Digital Commons Network^™

Nursing Staff’S Perception Of The Implementation Of The Obstetric Emergency Code Pink, Mareena Johnson

Walden Dissertations and Doctoral Studies

The local nursing practice problem addressed by this DNP doctoral project was the inconsistent and uneven response to obstetric emergencies within the health care setting. The purpose of this project was to evaluate the current implementation of the Code Pink protocol, identify any gaps or barriers in its effectiveness, and gather insights from nursing staff to propose refinements that would enhance its reliability and impact., The perception of nursing staff regarding obstetric emergency codes represents a critical dimension in the domain of maternal and neonatal health care, significantly influencing the efficacy of emergency responses and patient outcomes. Obstetric emergencies, such …

A Clinical Accuracy Study Protocol For A Saliva-Based Point-Of-Care Lateral Flow Test To Assess Protective Immunity To Tetanus (Tetanus Study), K Gokani, S E Faustini, C Tanner, H F Kwok, R Agarwal, Y Takwoingi, Semukunzi H, C Umuhoza, A Richter, J Nyombayire, C M Muvunyi, J Heaney, C A Green

Faculty, Staff and Students Publications

Introduction: Despite the availability of a safe and effective vaccine, 2000-3000 neonates die of tetanus yearly, predominantly in low- to middle-income countries (LMICs). Inaccurate coverage estimates and vaccination records, together with variability in vaccine response, make identifying individuals who lack protective immunity and may benefit from vaccination difficult. A more direct measure of protective immunity is widely accepted as anti-tetanus IgG concentration at or above 0.1 IU/mL. This study aims to evaluate the performance of a novel saliva-based point-of-care lateral flow test (CIS-IMMUNE Tet) for the binary classification of tetanus protective immune status (protected/unprotected) against WHO threshold-based classification of IgG …

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

Journal of Comparative & International Higher Education

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

Fatigue And Circadian Disruption In Long-Haul Ferry Pilots: Human Factors Challenges And Mitigation Strategies, Parneet Makkar

Discovery Day - Daytona Beach

Fatigue and circadian rhythm disruption present significant human factors challenges in long-haul aviation operations, particularly for ferry pilots (pilots responsible for transporting aircraft long distances between locations) who often travel across multiple time zones before beginning flight duties. Circadian rhythms regulate the human sleep-wake cycle and are closely tied to cognitive performance, alertness, and coordination. Rapid travel across time zones can disrupt these rhythms, producing symptoms commonly associated with jet lag such as sleep disturbances, fatigue, and reduced cognitive functioning. For ferry pilots, long travel periods and irregular schedules may increase the likelihood of fatigue before flight operations even begin. …

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

inSIGHT

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

Insight, Volume 6, Issue 1, 2026

inSIGHT

Contents

7 - Novel Treatments for Keratoconus
By Caroline Paik

12 - Novel Advancements in Glaucoma Surgery
By Eshani Ragam

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

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

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

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

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Staff Education To Address Verbal De-Escalation Skills In Correctional Mental Healthcare, Mary L. Goodman

Walden Dissertations and Doctoral Studies

This staff education project evaluated the effects of a structured verbal de-escalation training program on self-efficacy among staff in a federal correctional mental health unit. Staff at the site often reported uncertainty managing escalating behaviors, leading to frequent use of restrictive interventions like restraints and seclusion—practices that can compromise safety, quality of care, and raise ethical concerns. To address this gap, an evidence-based curriculum was implemented for 41 multidisciplinary staff, including nurses, certified nursing assistants, and correctional officers. The curriculum included a PowerPoint presentation, role play, and group discussion. A pre–post design measured changes in staff confidence using a modified …

Belonging And Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia Hickman

Papers

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

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

International Journal of Physical Activity and Health

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

Staff Education To Reduce Stress In Assisted Living Nursing Staff, Cherechi Onyenso

Walden Dissertations and Doctoral Studies

In this staff education doctor of nursing practice (DNP) project, I addressed a practice gap associated with inadequate staff knowledge of workplace stress-management strategies in an assisted living facility. Workplace stress in nursing practice is a contributing factor to burnout, reduced job satisfaction, poor teamwork, and a decline in the quality of resident care. The practice-focused question for this project was about whether staff knowledge would be enhanced over an 8-week period in comparison to baseline knowledge as a result of their participation in a structured staff education program on workplace stress management. The purpose of the project was to …

Staff Education To Standardize Chronic Pain Patient Education In Primary Care, Jessica Okpara

Walden Dissertations and Doctoral Studies

Inconsistent delivery and documentation of chronic pain patient education may contribute to variations in patient knowledge, treatment expectations, and engagement in self-management. This Doctor of Nursing Practice staff education and quality improvement project was designed to standardize chronic pain patient education in a primary care setting. The practice-focused question examined whether implementing standardized chronic pain education, compared with non-standardized education, would improve patient knowledge and use of self-management strategies over 10 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model, the project included development of evidence-based education materials, staff preparation, workflow integration, and a standardized documentation process. Clinic staff identified …

Reducing Nurse Burnout, Oluwarotimi Tunde Aborisade

Walden Dissertations and Doctoral Studies

Nurse burnout is a severe job-related condition that significantly impacts nurses' well-being. Nurse burnout is a growing concern amid the increased demand for healthcare professionals. Research has been conducted to explore nurse burnout and how it affects the quality and safety of patients. Different research has also been conducted to review different interventions to address nurse burnout, including individual and organizational interventions. Some interventions include self-care, mindfulness and meditation, coping and resilience, as well as lifestyle adjustments. Some organizational interventions include workload management, psychological safety, and job redesign. This study was conducted to evaluate the effectiveness of individual interventions to …

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …

Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler

Walden Dissertations and Doctoral Studies

Secondary postpartum hemorrhage (SPPH) is a significant contributor to maternal morbidity in the United States and occurs after hospital discharge during the postpartum period. Persistent disparities in terms of maternal outcomes suggest access to prenatal care alone may not adequately address clinical and social factors associated with SPPH. Guided by the Social Ecological Model, which recognizes that health outcomes are influenced by a collective approach to examining health. The purpose of this study was to examine associations between SPPH, prenatal care access, and social determinants of health from 2019 to 2022 while controlling for maternal age, race, and delivery type. …

Staff Education To Improve Knowledge On Accurate Administration Of Medication, Deepu Pudasaini

Walden Dissertations and Doctoral Studies

Medication errors have been a significant problem, primarily due to a lack of continuous monitoring and inadequate training for personnel involved in managing or administering medications in non-healthcare settings. These errors often go undetected or unreported. This Doctor of Nursing Practice (DNP) project was a staff education project to improve staff knowledge of accurate medication administration of medication in a group home. The practice-focused question was: Will a staff education program on the accurate administration of medication improve certified medication technicians’ (CMTs) knowledge about the association between the medication administration process and medication error? The purpose of this DNP staff …

Improving Identification And Initial Management Of Perimenopause In Primary Care, Yewande Banire

Walden Dissertations and Doctoral Studies

Perimenopause is a common but frequently underrecognized stage of reproductive aging that can significantly affect women's physical, psychological, cognitive, and sexual well-being. In primary care, inconsistent provider education and the absence of standardized screening and assessment processes often contribute to delayed recognition and fragmented management. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based clinical practice guideline to improve the identification and initial management of perimenopause in a primary care setting. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved synthesizing and critically appraising the literature to develop …

Educating Psychiatric Mental Health Nurse Practitioners On Long-Acting Injectable Antipsychotic Medication Management, Omonzua Mabel Eromosele

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed the underutilization of long-acting injectable (LAI) antipsychotic medications in an outpatient mental health center. Although LAI antipsychotics improve medication adherence, reduce relapse, and decrease psychiatric hospitalization, provider knowledge deficits and inconsistent prescribing practices lead to their underuse. The practice-focused question was: Among psychiatric-mental health nurse practitioners (PMHNPs) in an outpatient mental health center, what is the impact of an educational program on the application of LAI antipsychotic medication management on the improvement of staff knowledge? The purpose of this project was to implement and evaluate evidence-based educational intervention to improve …

Relationship Identification Between Triggers And Changes In The Brain And The Overall Human Electrophysiology During Migraines, Dominic Sandell, Jonah Dematto, Gianpiero Lara, Jasmine Rosales, Legacy Wilson, Zachary Young

Discovery Day - Daytona Beach

One of the most common neurological conditions in the world is migraines; nearly 1/4th of the working population suffers from this condition and exhibits a large variety of triggers. The current treatment method for migraine uses few different medications for all migraines, regardless of triggers. Our hypothesis is that there is a specific relationship between the triggers of migraines and the electrical changes in the brain during migraines. It is known that electrical activity in the brain occurs during migraines; it is unclear whether these changes differ across triggers. The study incorporates two different data collection methods: electrophysiological tests (Electroencephalogram …

Deaths Of Despair Among Cancer Survivors In Rural/Urban Appalachia (2000-2022), Jason Semprini, Anders Erickson, Nosa Osazuwa-Peters

Journal of Appalachian Health

Introduction: Rising deaths of despair (premature deaths from suicide, overdose, alcohol, and violence) in adults under age 65 persist across the United States, especially in Appalachia. People diagnosed with cancer may face elevated risks of such deaths due to pain, psychosocial distress, and financial hardship.

Purpose: Deaths of despair trends were compared among adults with cancer across Appalachian and non-Appalachian regions, stratified by sex and rurality.

Methods: Analyzing SEER-21 Incidence-Based Mortality data (2000–2022), deaths caused by suicide, cirrhosis of the liver, or accidents (includes overdose) were identified among adults aged 20–64 years. Annual mortality rates per 100,000 total population were …

Exercise Intensity And The Effects On Mood And Wellbeing, Emily Amortegui, Ashley Albert, Riley Ensor, Keyanna Keyanna Jackson

Discovery Day - Daytona Beach

With many students dealing with anxiety, sadness, and high levels of stress, mental health issues among college students have grown in intensity. A lot of research has been done on the possible benefits of physical activity for mental health, but most of it focuses on correlations rather than the biological mechanisms. The purpose of this study is to examine the effects of varying exercise intensities on physiological stress markers and mood in college students ages 18 to 25. To assure precise intensity levels, participants from Embry-Riddle Aeronautical University will work out at low, moderate, and high intensities while wearing heart …

The Effect Of Snris On Pilot Reaction Time In Simulated Flight, Isabella Owen, Aidan Roach, Micah Henry, Casey Tressler

Discovery Day - Daytona Beach

Many aviators who are prescribed serotonin and norepinephrine reuptake inhibitors (SNRI) or selective serotonin reuptake inhibitors (SSRI) to treat mental health disorders such as major depressive disorder, general anxiety disorder, or post-traumatic stress disorder must halt their duties for a set amount of time. This is due to aviation authorities having data that suggests SNRIs and SSRIs lead to inhibitions in mental processes that can cause crashes or death. Most of the research that has been conducted examined the effects of SSRIs on individuals without mental health disorders in non-flight settings. This study will explore the effect SNRIs have on …

Effects Of Sleep Duration And Perceived Stress Of Reaction Time In Undergraduate Students, Caitlin Wescott, Edna Urrutia, Ryan F. Rednick, David Still

Discovery Day - Daytona Beach

Sleep deprivation and psychological stress are common among undergraduate students and can negatively affect cognitive performance. Reaction time is an important indicator of attention and processing speed and plays a critical role in both everyday activities, such as driving, and high-performance environments where rapid responses are required. This study aims to examine how sleep duration and perceived stress levels influence reaction time in undergraduate students. Participants will report their sleep duration and perceived stress levels through short surveys and wearable sleep data, while reaction time will be measured using a standardized computerized reaction time test. By comparing reaction time across …

Fieldwork Educators' Perspectives On Occupational Therapy Students Addressing Sexuality And Intimacy: Expectations, Supports, And Barriers, Elizabeth Deluca-Berg

Student Dissertations

Sexuality and intimacy are recognized as meaningful occupations within occupational therapy practice; however, they remain inconsistently addressed in clinical care. Previous research has identified limited educational preparation as a contributing factor to occupational therapists' discomfort and lack of confidence in addressing these occupations. Although classroom instruction provides foundational knowledge, Level II fieldwork serves as the primary setting in which students apply knowledge within authentic clinical environments. Despite the central role of FW educators in facilitating students' professional development, little research has explored how they prepare OT students to address sexuality and intimacy during fieldwork. The purpose of this basic qualitative …

Enhancing Cultural Competency Through Training In A Primary Care Clinic, Rogelio Perez Iii

Doctor of Nursing Practice Projects

Cultural competence remains essential in primary care settings serving diverse populations, yet staff at a small Southern Texas primary care clinic reported no previous formal cultural competency training in workplace orientation or school. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a brief, evidence-based cultural competency intervention improved clinician cultural competency scores. Madeleine Leininger’s Culture Care Theory provided the theoretical framework, Lewin’s Change Theory guided the change process, and the Plan-Do-Study-Act cycle directed implementation and evaluation. The problem addressed was the lack of structured training to support culturally responsive communication, patient trust, and …

Enhancing Mental Health Support For Motor Vehicle Accident (Mva) Survivors Through Occupational Therapy (Ot)-Led Support Groups, Emma K. Gooden Ms

Occupational Therapy Doctorate Capstone Posters

This doctoral capstone project, completed during a 14-week Applied Leadership Experience (ALE) with Georgetown-Scott County EMS (GSCEMS), focused on the ACOTE target areas of Program Development and Advocacy by creating an evidence-based, trauma-informed, occupational therapy support group curriculum for motor vehicle accident (MVA) survivors. A literature review and needs assessment identified a significant gap in post-crash care, as many survivors experience long-term psychological challenges—including PTSD, anxiety, depression, fear of driving, and disruptions in daily roles—despite care often emphasizing physical rehabilitation over emotional recovery. Drawing from observations of GSCEMS Peer Support and Critical Incident Stress Management meetings, current evidence, and ongoing …

Breast Cancer Knowledge, Awareness And Screening Practices Among Female Healthcare Workers In Al-Mukalla, Yemen, Wafa Al Shoaeeb, Ahmed M. Badheeb, Faisal Ahmed, Amen Bawazir, Abdulla Bin Nabhan, Mohammed Badheeb, Abdulkader Bayazid

Sultan Qaboos University Medical Journal

Objectives: Breast cancer (BC) is the most common malignancy among women worldwide and represents a significant burden for Yemeni women. Early detection through breast self-examination (BSE) and knowledge of risk factors and symptoms are crucial. This study aimed to assess awareness, knowledge and practice regarding BC risk factors, symptoms and BSE among female healthcare workers (HCWs) in Al-Mukalla, Yemen. Methods: This cross-sectional study was conducted from September to October 2022 at three public hospitals in Al-Mukalla, Yemen. A census sampling approach was used to recruit HCWs. Data were collected using a validated self-administered questionnaire covering breast awareness practices, risk …

Understanding Brain Fog During Menopause, Cris Meier, Moth Huenemann, Ashley Yaugher, Cara Murray

All Current Publications

Brain fog is an inability to concentrate or think clearly and is a common symptom of perimenopause and early in the menopause phase. While not everyone who goes through menopause will have brain fog, it is a common symptom, and it can be helpful to understand why brain fog occurs. This fact sheet provides helpful information to understand brain fog and ideas you can use to manage it.