Digital Commons Network^™

Quality Improvement Project: Improving Psychiatric Provider Confidence In Prescribing Long-Acting Injectable (Lai) Antipsychotics Through A Structured Education Program, Emile Bihnyuy

Doctor of Nursing Practice Projects

Schizophrenia is a disorder that affects about 24 million people globally and needs regular antipsychotic drug management to prevent relapse. Although long-acting injectable (LAI) antipsychotics are associated with better adherence to and fewer relapses than oral antipsychotics, their use is underutilized in outpatient psychiatric care. This quality improvement project aimed to increase psychiatric providers' confidence in the prescribing of LAIs by implementing a structured 12-week education program in an outpatient psychiatric clinic in Texas. The implementation was guided by the Iowa Model of Evidence-Based Practice and the change process informed by Lewin's Change Model. Four psychiatric providers completed the modified …

Quality Improvement Project: The Impact Of Proper Utilization Of Suicidal Ideation Screening Tools, Anuoluwapo Bode-Oloye

Doctor of Nursing Practice Projects

Suicide remains a significant public health concern, emphasizing the importance of consistent and evidence-based suicide risk assessment in outpatient mental health settings. The purpose of this Doctor of Nursing Practice quality improvement project was to determine how the provider’s implementation of the Columbia Suicide Severity Rating Scales (CSSRS) according to the recommendations of the Substance Abuse and Mental Health Services Administration would impact the confidence and the rate of completion of suicidal screening tools (Columbia Suicide Severity Rating Scales) compared to current clinic policy in an outpatient mental health clinic for over twelve weeks. This project used Lewin’s change model …

Quality Improvement Project: The Impact Of Provider Education On Antipsychotic Medication Side Effects, Anthony Emego

Doctor of Nursing Practice Projects

Weight gain is a frequent and clinically relevant side effect of antipsychotic medication. A needs assessment at the project site found that roughly 55% of patients on an antipsychotic treatment had clinically significant weight gain, and providers had no formal training on how to prevent and manage this. The purpose of this quality improvement project was to determine if a provider-focused educational intervention is effective in increasing provider confidence and decreasing antipsychotic-induced weight gain in adult psychiatric patients. This quantitative, one-group pre-post design utilized Lewin's Change Theory and Bandura's Social Cognitive Theory. It was conducted at an outpatient psychiatric clinic …

The Impact Of Provider Education On Medication Adherence In An Outpatient Psychiatric Clinic: A Quality Improvement Project, Tina Ezeh

Doctor of Nursing Practice Projects

Medication adherence is important in psychiatric care, as nonadherence can contribute to poor health outcomes and increased use of healthcare services. A needs assessment at an outpatient psychiatric clinic identified inconsistent medication adherence education, with only 30% of providers routinely providing education and 20% using a structured approach. The purpose of this quality improvement project was to evaluate structured provider education, with the aim of assessing changes in provider confidence and the frequency of medication adherence education over eight weeks. Kotter’s 8-Step Change Model guided project implementation, while the Donabedian Model was used for project evaluation. A quantitative, one-group pretest-posttest …

Quality Improvement Project: Evaluating The Impact Of An Emotional Support Program For Nurses In A Rural Outpatient Clinic, Tosheta Brown Greenfield

Doctor of Nursing Practice Projects

Nurse burnout is a persistent, well-documented threat to workforce sustainability and patient safety, with rural nurses at heightened risk due to chronic understaffing, geographic isolation, and limited access to organizational support. The purpose of this quality improvement project was to implement and evaluate an eight-week Emotional Well-Being Support Program (EWSP), with the aim of reducing burnout and perceived stress among nurses working in a small rural primary care clinic. Guided by Lewin's Change Model and the Iowa Model of Evidence-Based Practice, the project used a quasi-experimental pre-test/post-test single-group design with four participating nurses. Burnout was measured using the Maslach Burnout …

Quality Improvement Project: Providing Evidence-Based Practice Education On Administering The Edinburgh Postnatal Depression Screening During Visits Once Per Trimester And Postpartum, Megan Keeney

Doctor of Nursing Practice Projects

Perinatal depression (PND) is prevalent worldwide and frequently remains undetected and untreated due to inconsistent screening. At the project site, the Edinburgh Postnatal Depression Scale (EPDS) was administered postpartum only, without standardization. This quality improvement project implemented evidence-based provider education and a revised EPDS protocol, screening once per trimester and postpartum, to increase PND identification, provider self-confidence, self-efficacy, and behavioral health referral rates. This project was guided by Lewin’s Change Theory and the Donabedian framework. A quantitative pre-post design was used with nine providers in an outpatient women’s health clinic, alongside a retrospective and post-implementation electronic health record (EHR) review. …

Evaluation Of Disaster Mitigation Policy Implementation And Public Health Integration Through The “Sipatokkong” Program In Strengthening Tourism Village Resilience, Nurul Azisah Sahrani, Andi Alif Raihan Analta

Journal of Indonesian Health Policy and Administration

Disaster risks in tourism villages are increasing, generating multidimensional impacts on environmental, economic, institutional, and public health. In late 2024, Mattabulu Tourism Village experienced an 83% decline in tourist visits following a series of disasters, disrupting tourism activities and weakening local governance capacity. This study uses a qualitative case study design to evaluate disaster mitigation policy implementation through the “Sipatokkong” Program. Evaluation applied four Organisation for Economic Co-operation and Development–Development Assistance Committee (OECD-DAC) criteria: relevance, effectiveness, impact, and sustainability, operationalized through policy implementation, street-level bureaucracy, and collaborative governance frameworks. Data were obtained from five documents and non-participatory field observations conducted …

Eeg-Emg Coupling And Functional Neuroplasticity In Elite Combat Athletes: Effects Of Neurofeedback Training On Corticomuscular Coherence And Performance, Alicja Markiel, Kinga Łosińska, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Neurofeedback training has gained attention as a neuroplasticity based intervention for athletic performance, yet pathways linking cortical oscillatory modulation to neuromuscular adaptation and strength remain poorly characterized in elite combat athletes. Objective: This study examines whether EEG neurofeedback targeting sensorimotor alpha upregulation and frontal theta/delta modulation enhances cortico-muscular coherence, neuromuscular function, and maximal strength in elite MMA athletes. Methods: Thirty elite male MMA athletes (n = 10/arm) were randomized to intensive neurofeedback (E20G, 20 sessions), abbreviated neurofeedback (E15G, 15 sessions), or sham control. EEG spectral indices, EMG parameters (RMS, MF, iEMG, onset latency), beta band CMC, and maximal strength …

Chacahoula 2026, Volume 93, Pawan Khatri, Alayna Pellegrin

Chacahoula

The 2026 issue of Chacahoula, There's No Place Like Home, emphasizes the way in which our university becomes a home to students.  Featuring prize-winning poetry from Allyson Gee, Nick Fredrick, Amaris Kendall and Anmol Subedi, the book includes December 2025 and May 2026 graduating classes, as well as stunning photography of  campus life on the banks of Bayou Desiard. With features covering students, faculty, and staff, this year's time capsule preserves an academic year in the life of the University of Louisiana at Monroe. This edition includes a video message from President Carrie Castille. Download the PDF to your device …

Levofloxacin-Ketoprofen Multicomponent Salt Development As A Strategy To Improve The Antibiotic Potency And Anti-Inflammatory Performance, Ilma Nugrahani, Nadhira Dzaky Naushafira, Nova Suliska, Marlia Singgih Wibowo, Hana Fauziah

Makara Journal of Science

Levofloxacin is a fluoroquinolone antibiotic with higher solubility than those from previous generations, but it is light-sensitive. Antibiotics, including levofloxacin, are generally prescribed in combination with nonsteroidal anti-inflamma-tory drugs (NSAIDs) to treat inflammatory infections. Furthermore, NSAIDs have poor water solubility, which can be improved by forming salts or multicomponent systems. This study aimed to develop a multicomponent system from levofloxacin with ketoprofen, an NSAID, and to evaluate its physicochemical characteristics; antibiotic potency; in vivo anti-inflammatory activity; absorption, distribution, metabolism, and excretion (ADME); and in silico toxicity risk. First, a phase diagram was created to predict the interaction type in the …

Nuclear Neuroimaging Approaches To Traumatic Brain Injury: Current Insights And Future Directions, Shivani Daksh, Anupriya Adhikari, Nikhil Kumar, Garima Mann, Anupama Datta

Makara Journal of Science

The aftermath of a traumatic brain injury is characterized by a state of disruption, progressing into secondary injury and culminating in a complex network of interconnected pathophysiological disturbances.  The potential risk of developing neurological disorders after TBI highlights the pressing need to enhance our understanding and develop therapeutic in-terventions to alleviate its devastating consequences. Traumatic brain injury can lead to a range of problems, including pain, swelling, axonal degeneration, and chronic amnestic and non-amnestic cognitive impairments. The first and essential step in the management of TBI is to identify and characterize the clinical symptoms. This systematic review outlines the established …

Bambara Groundnut (Vigna Subterranea L.) Supplementation Ameliorates The Histological Structure Of Skeletal Muscle In Protein-Deficient Mice, Raquellynda Fadilla Syafanisa, Rimonta Febby Gunanegara, Sunarti Sunarti, Siti Aeniah, Ardaning Nuriliani

Makara Journal of Science

Protein deficiency may cause histological alterations and pathological effects in skeletal muscle, leading to reduced mus-cle size and functional degeneration. Bambara groundnuts contain essential amino acids that have the potential to meet the body’s protein requirements. Therefore, this study aimed to investigate the effect of bambara groundnut supplemen-tation on skeletal muscle in protein-deficient mice. Twenty-five female mice were divided into five groups (control, pro-tein deficiency, and protein deficiency with 100, 200, and 300 g of bambara groundnut supplementation/kg of feed). The treatment was administered for 2 months. At the end of the experiment, the left gastrocnemius muscles of the mice …

Network Pharmacology Of A Decaffeinated Green Coffee–Turmeric Combination: Potential Therapeutic Activity Against Hypertension And Diabetes Mellitus, Feri Eko Hermanto, Mohammad Saifur Rohman, Victor Alvianoes Guterez Hose, Mifetika Lukitasari, Dwi Adi Nugroho, Nashi Widodo, Inggita Kusumastuty

Makara Journal of Science

Decaffeinated green coffee and turmeric are recognized for their protective effects against hypertension (HTN) and diabetes mellitus (DM). Combining them into a functional drink, green coffee and turmeric (GCT), offers potential health benefits for managing these conditions. This study explored the bioactivity of GCT in HTN and DM through network biology, identifying intersecting protein targets and their roles in inflammation and glucose metabolism. Key proteins identified were AKT1, CCL2, CXCL8, IL-1β, and IL18. Molecular docking revealed that GCT compounds, particularly Cafestol, Chlorogenic Acid, Kahweol, Curcumin, and Desmethoxycurcumin, interacted strongly with AKT1 at its allosteric site, potentially inhibiting its activity. However, …

The Impact Of Implementing A Discharge Tool On Nurses’ Confidence And Press Ganey Patient Survey Scores In Discharge Planning, Cristan Ledbetter

Doctor of Nursing Practice Projects

A needs assessment at a rural hospital revealed an opportunity for improvement in discharge planning. The purpose and aim of this project was to improve nurses’ confidence in the discharge process and improve Press Ganey survey scores in communication about medicine domain and discharge information domain. Inadequate discharge planning leads to poor patient outcomes, concern for patient safety, increased healthcare costs, and inferior patient satisfaction. The quality improvement (QI) project utilized a one-group pretest/posttest QI design. An evidence-based, standardized discharge tool was implemented. The Susan Grundy confidence scale (C-Scale) was used to evaluate nurses’ confidence in the discharge process pre- …

Enhancing Healthcare Provider Confidence And Accuracy In Performing And Documenting The Abnormal Involuntary Movement Scale, Victoria Okoani-Nneji

Doctor of Nursing Practice Projects

Monitoring for medication-related movement disorders is essential for adults with schizophrenia receiving antipsychotic medications; however, inconsistent Abnormal Involuntary Movement Scale (AIMS) assessment and documentation can limit timely recognition of abnormal movements. This quality improvement project evaluated a six-week structured AIMS education program designed to improve provider confidence and documentation accuracy in an outpatient behavioral health setting in Central Ohio. Guided by Benner’s Novice-to-Expert Model and Kotter’s Eight-Step Change Model, the project used a one-group pretest-posttest design with 15 licensed behavioral health providers. Weekly sessions included instruction, demonstration, guided practice, case-based learning, scoring, interpretation, and electronic health record (EHR) documentation. Descriptive …

Quality Improvement Project: Determining Impact Of Mental Health Screening Provider Training, Sherri Bennett

Doctor of Nursing Practice Projects

Obesity is frequently associated with mental health concerns, yet these conditions may remain under identified when mental health screening is not consistently incorporated into medical weight-loss care. At the project site, fewer than 2% of patients who are overweight or obese were identified as needing mental health services, demonstrating a practice gap in screening and referral. The purpose of this quality improvement project was to evaluate whether targeted mental health screening education improved provider confidence. The aim was to increase confidence in conducting mental health screening among nurse practitioners in a medical weight-loss program. The Stetler Model provided the theoretical …

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …

Perceived Susceptibility And Automatic Compliance In Indonesia's Triple Elimination Screening: A Mixed-Methods Study, Ratna Dewi Puspita Sari, Josef Maria Seno Adjie

Journal of Indonesian Health Policy and Administration

Despite global commitments to eliminating mother-to-child transmission of human immunodeficiency virus, syphilis, and hepatitis B, gaps remain in understanding the behavioral and systemic drivers of screening coverage in decentralized health systems such as Indonesia. This study aimed to analyze individual behavioral determinants and structural health system barriers affecting triple elimination screening coverage among pregnant women, focusing on perceived susceptibility and automatic compliance. A mixed-methods sequential explanatory study was conducted in Central Jakarta, Surabaya, and Karawang. The quantitative phase involved a cross-sectional survey of 1,224 pregnant women, with Health Belief Model variables analyzed using logistic regression. The qualitative phase comprised three …

Quality Improvement Project: Improving Nurses’ Confidence In Peripheral Intravenous Catheter Assessment Through The I-Decided Framework, Pepe Sanchez

Doctor of Nursing Practice Projects

Peripheral intravenous catheters (PIVCs) remain a patient safety concern because inappropriate management can increase the risk of catheter-related bloodstream infections, prolonged hospitalization, and increased healthcare costs. A vascular access assessment at an acute care hospital identified inconsistent PIVC assessment practices and inadequate documentation, highlighting the need for a standardized approach to vascular access management. This quality improvement project evaluated the impact of education on the I-DECIDED framework on nurses' confidence in PIVC assessment and clinical decision-making. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Lewin's Theory of Planned Change, the project used a quantitative, quasi-experimental, one-group pretest-posttest design. …

Determining Impact On Provider Adherence To Current Diabetes Guidelines: A Quality Improvement Project, Rashemia Suber

Doctor of Nursing Practice Projects

The delivery and documentation of evidence-based adult lifestyle counseling for patients with type 2 diabetes mellitus (T2DM) were found to be inconsistent in a clinic that serves an underserved population. This quality improvement (QI) project assessed whether a provider education program based on the 2025 American College of Lifestyle Medicine (ACLM) Diabetes Guidelines would improve provider confidence and documentation of lifestyle recommendations. A quasi-experimental, pretest-posttest design was guided by both Pender's Health Promotion Model as the theoretical framework and Lewin's Change Theory as the change theory. The Plan Do Study Act (PDSA) cycle guided this project as the implementation framework. …

Social And Psychological Well-Being Of Aps Clients With Elder Mistreatment And Self-Neglect, Thara Ayyar

Summer Research Program Abstracts

No abstract provided.

The Importance Of Biopsy In New Lower Extremity Lesions: A Case Of Kaposi Sarcoma, Michael A. Higham, Stephanie N. Campbell, Naomie Jean, Amanda L. Killeen

School of Podiatric Medicine Publications

Introduction: Kaposi sarcoma is a vascular neoplasm associated with human herpesvirus-8 (HHV-8) that may present with atypical cutaneous findings in the lower extremity. Delayed diagnosis may occur when lesions resemble benign wounds or hypergranulation tissue, particularly in patients without a known oncologic history.

Aim: To present an atypical pedal presentation of Kaposi sarcoma initially encountered as a new lateral foot wound in an elderly patient with peripheral arterial disease and neuropathy.

Methods: An 80-year-old Hispanic male presented with a new “wound” of unknown duration on the lateral aspect of the left foot. Physical examination demonstrated xerotic skin with mild erythema …

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 …

Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …

Evaluating Platelet-Rich Plasma For Diabetic Foot Ulcer Healing: A Scope Review, Sairakshitha Yalla, Sarah Morales, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Chronic diabetic foot ulcers (DFUs) are becoming increasingly common with the rising prevalence of diabetes. These wounds are often difficult to heal due to the complex complications associated with the disease. Platelet-rich plasma (PRP), traditionally utilized as an adjunctive therapy for musculoskeletal injuries, has more recently been applied topically to promote the healing of DFUs.

Aims: To analyze if PRP heals DFUs faster than the standard of care.

Methods: A scoping review of PubMed and Google Scholar (2016-2026) was conducted. Inclusion criteria were published in the English language, randomized controlled trials involving adults, utilizing autologous PRP.  Exclusion criteria included …

A Hypothalamic Neuronal Population Coordinates Metabolic Adaptations To Cold, Hailan Liu, Qingzhuo Liu, Jonathan C Bean, Fuhui Wang, Jinjing Jian, Yongxiang Li, Kristine M Conde, Mengjie Wang, Yue Deng, Yuxue Yang, Tong Zhou, Jingjing Cheng, Yutian Liu, Meixin Sun, Xinming Liu, Jiamin Qiu, Xi Wu, Lamei Xue, Qingchun Tong, Benjamin R Arenkiel, Mingshan Xue, Huxing Cui, Tzu-Chiao Lu, Yanyan Qi, Hongjie Li, Chunmei Wang, Yang He, Yongjie Yang, Longlong Tu, Yong Xu

Faculty, Staff and Students Publications

Cold exposure increases feeding, thermogenesis, and energy expenditure to maintain body temperature and energy balance, but the underlying neural mechanisms remain unclear. Here, we identify cold-responsive neurons in the dorsal posterior periventricular hypothalamus that coordinate these adaptations. Activation of GABAergic or cold-activated neurons increased food intake, body temperature, and brown adipose tissue thermogenesis, whereas their inhibition attenuated cold-induced hyperphagia and thermogenesis. Single-nucleus RNA sequencing identified Lef1 as a marker of cold-activated neurons in this region. Activation of Lef1+ neurons recapitulated key cold responses, whereas silencing attenuated them. Lef1 positively regulated Kcnk2, which encodes the cold-sensitive potassium channel TREK-1. Cold …

Differences In Mental Toughness Among Mixed Martial Artists And Physically Active Individuals, Savannah M. Calleja, Soleil Ramos, Victoria Potvin, Anthony A. Ricci, Gabriel J. Sanders, Corey A. Peacock

Journal for Sports Neuroscience

Mixed Martial Arts (MMA) is a physiological and psychological demanding sport. While the majority of the literature conducted in MMA regards physiological health and risk of injury, researchers are beginning to assess the psychological profiles of MMA athletes. Previous studies have evaluated mental toughness (MT) within MMA; however, no study has examined MT in MMA athletes at the professional division. Therefore, the primary purpose of this research was to evaluate the difference in mental toughness between professional MMA athletes and physically active individuals. Secondary aims are to evaluate potential variations in mental toughness within the professional level between champion and …

Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran

Walden Dissertations and Doctoral Studies

Routine preventive care supports early identification and management of health conditions among adults at high risk for pancreatic cancer. Evidence is limited regarding socioeconomic and health care access factors associated with engagement in routine preventive care among Florida adults aged 65 years and older at high risk for pancreatic cancer. The purpose of this quantitative cross-sectional correlational study was to examine these associations among this population. The health belief model served as the theoretical framework. Secondary data from the 2022 Florida Behavioral Risk Factor Surveillance System were analyzed for N = 4,032 participants using two multivariable binary logistic regression models …

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 …

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 …