Digital Commons Network^™

Frailty And Fall Risk In Older Adults With Type 2 Diabetes: A Cross-Sectional Study, Hatice Yılmaz, Nazmiye Çıray

Makara Journal of Health Research

Background: This study aimed to examine the effect of frailty on the risk of falls in older adults aged 65 years with type 2 diabetes.

Methods: The study is cross-sectional and correlational. The sample included 146 individuals aged 65 years who had type 2 diabetes and visited the internal medicine outpatient clinic of a state hospital in Türkiye. The participants were assessed based on a personal information form, the Mini-Mental State Examination, Edmonton Frail Scale, Morse Fall Scale, and Katz Index of Independence in Activities of Daily Living. IBM SPSS Statistics version 22.0 was used for data analysis. …

Examination Of Health-Seeking Behavior In Individuals With Chronic Diseases, Dilan Aktepe Coşar, Hatice Demirağ, Aynur Cin

Makara Journal of Health Research

Background: Chronic illnesses are long-term, noncommunicable diseases that significantly affect daily life. In addition to physical symptoms, they can reduce quality of life by causing psychological effects such as anxiety and depression. Patients often seek health information to better manage their condition.

Methods: This study aimed to examine the level of health information-seeking behavior among individuals with chronic diseases and the factors influencing this behavior. The sample group for this descriptive study consisted of 306 individuals with chronic illnesses who visited X Hospital in northeastern Türkiye between April 1, 2024, and February 1, 2025. All individuals completed a …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

The Mediating Role Of The Care Factor In The Effect Of Nomophobia On Nurses’ Job Satisfaction, Uğur Öner, Sinan Aslan, Erhan Ekingen

Makara Journal of Health Research

Background: This study aimed to examine the mediating role of the Care Factor in the relationship between nomophobia and job satisfaction among nurses.

Methods: A descriptive, cross-sectional study was conducted with 1,083 nurses working in a province in Turkey between May and September 2024. Data were collected using a Descriptive Form, the Fırat Nomophobia Scale (FNS), the Care Factor Scale (CFS), and the Job Satisfaction Scale for Nurses (JSSN). All analyses were performed using SPSS 25, including descriptive statistics, Pearson correlation, and regression. Mediation was tested using PROCESS Macro version 4.0 (Model 4).

Results: The CFS-CS and …

Breathing-Controlled Electrical Stimulation (Breestim) Selectively Modulates Affective And Cognitive Components Of Pain-An Eeg Study, Ahmad Z Rao, Michael Houston, Hao Meng, Shengai Li, Yingchun Zhang, Sheng Li

Faculty, Staff and Student Publications

Breathing-controlled electrical stimulation (BreEStim) is an innovative neuromodulation intervention that synchronizes deep voluntary breathing with peripheral electrical stimulation. Prior studies have shown its analgesic effects in healthy adults and spinal cord injury patients with neuropathic pain. The present study used EEG to examine BreEStim's neural effects on sensory, affective, and cognitive components of pain. Fourteen healthy participants (7 M, 7 F) completed 30 min of BreEStim and conventional electrical stimulation (EStim) interventions in a randomized, crossover within-subject design. Electrical pain thresholds (EPT) and EEG were recorded pre- and post-intervention. Event-related potentials (ERPs) at pre-EPT-level stimuli before and immediately after each …

An Atlas Of Human Siglecs Integrates Expression, Affinity, And Cis/Trans Sialoglycan Recognition Profiles, Shani Leviatan Ben-Arye, Edward N Schmidt, Zeinab Jame-Chenarboo, Claire Guetta-Oz, Fahima Mozaneh, Jaesoo Jung, Kelli A Mccord, Ronit Rosenfeld, Kan Zhong, Hongzhi Cao, Hai Yu, Xi Chen, Lori J West, Matthew S Macauley, Vered Padler-Karavani

Faculty, Staff and Students Publications

All living cells have a sugar-coat that facilitates communication. Sialic acids cap mammalian glycans and are recognized by immune cells through sialic acid-binding immunoglobulin-like lectins (Siglecs) that regulate signaling by their cytoplasmic motifs. Inconsistent reports of Siglecs expression and sialoglycan recognition limit their therapeutic potential. Here we investigate 14 functional human Siglecs for their expression, glycan interactions and affinities. SIGLEC mRNA is broad in blood-derived monocytes and dendritic cells, restricted in natural-killer/B cells and absent in T cells, with similar Siglec-proteins expression in splenocytes. Binding to 114 glycans across 274 glycan microarrays, 220 splenocytes-assays and 132 cell-based arrays, reveal Siglecs …

Ai-Based Facial Expression Detection As A Support Feature For Cybercounseling: A Systematic Literature Review, Zahid Zufar At Thaariq, Hengki Tri Hidayatullah

Buletin Konseling Inovatif

The rapid expansion of digital mental health services has increased the use of cybercounseling, while simultaneously introducing challenges in interpreting nonverbal cues, particularly facial expressions, within technology-mediated interactions. This study aims to systematically examine the potential of artificial intelligence (AI) in facial expression detection as a support feature in cybercounseling. A systematic literature review (SLR) was conducted following PRISMA guidelines, drawing from multiple indexed academic databases. The included studies covered AI-based facial expression recognition, micro-expression analysis, depression detection, and relevant multimodal approaches. The findings indicate that deep learning–based models are capable of identifying facial patterns associated with emotional and psychological …

Implementing A School Nurse-Facilitated Communication And Tracking Bundle To Improve Vision Care Follow-Up Rates, Natalie Autumn Johnston

ONU Student Research Colloquium

Abstract

Problem: Children’s cognitive, physical, and social development are influenced by vision. This means that early interventions in school-aged children are critical. While school-based vision screenings are standardized and effective in identifying visual deficits, post-screening follow-up rates with eyecare professionals remain low. This trend is especially prevalent in underserved school districts, perpetuating systemic healthcare gaps.

Purpose: The purpose of this study is to evaluate whether the rates of follow-up eye care among school-aged students who fail vision screening will improve following the implementation of school nurse facilitated follow-up communication and referral tracking bundle.

Methods: This study will …

Behavioral Effects Of Cocaine After Activation Of Cb1 Cannabinoid Receptors In Male And Female Mice, Cade Baughman, Jejun Lee, Jessica Acheampong, Jihoon Choi, Sarah Seeley, Manoranjan Dsouza

ONU Student Research Colloquium

The goal of this study was to assess the behavioral effects of cocaine following activation of CB1 cannabinoid receptors in male and female mice. This study was undertaken because recently published data suggest sex-dependent behavioral differences after CB1 receptor activation. However, the sex-dependent effects of CB1 receptor activation on the rewarding and psychomotor effects of cocaine have not been systematically evaluated. This study aimed to address this gap in knowledge. The study will use adult male and female C57BL6 mice. CB1 receptors will be activated using synthetic cannabinoid WIN 55212. Behavioral effects assessed after CB1 receptor activation will include both …

Effects Of Limb Dominance On Dopaminergic Neurodegeneration In A 6-Ohda Rat Model Of Parkinson’S Disease Assessed By Immunoblotting, Jasin Aziz Porshia, Deanna Chaialee, Dipesh Pokharel, Kala Venkiteswaran, Thyagarajan Subramanian, Dilshan Beligala

ONU Student Research Colloquium

Effects of Limb Dominance on Dopaminergic Neurodegeneration in a 6-OHDA Rat Model of Parkinson’s Disease Assessed by Immunoblotting

Jasin Porshia^a , Deanna Chaialee^a , Dipesh Pokharel^b,c , Kala Venkiteswaran^{b, c, d} , Thyagarajan Subramanian^{b, c, d}, Dilshan Beligala^a

^aDepartment of Biological Sciences, Ohio Northern University, Ada, OH, USA

^bDepartment of Neurosciences and Psychiatry, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA

^cDepartment of Neurology, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA

^dDepartment of Neurology, Howard University, Washington, DC, …

A Single Administration Of Psilocybin Is Ineffective In Reversing Ptsd-Like Sequelae In A Rat Model Of Stress-Enhanced Fear Learning, Kylie M. King, Marisa J. Savini, Noelle M. Molnar, Evelynn J. Schneider, Savannah E. Straub, Joe Parker, Lillianna P. Puppel, Aleece K. Al-Olimat, Allison M. Bach, Phillip R. Zoladz

ONU Student Research Colloquium

Single treatments with psychedelics produce rapid, long-lasting antidepressant effects. Psychedelics may also exert anxiolytic effects and be useful in treating more complex psychiatric conditions, such as PTSD. However, less is known about the impact of these agents on PTSD-related symptoms. Thus, we aimed to determine whether a single administration of psilocybin could reverse PTSD-like sequelae induced by stress-enhanced fear learning in rats. Sprague-Dawley rats were placed in Context A (circular, white conditioning box) and exposed to several uncontrollable footshocks (Stress) or no footshocks (No Stress). The next day, the rats were placed in Context B (square conditioning box with clear …

Psilocybin And The Related Tryptamine, Norbaeocystin, Exert Acute Anxiogenic Effects That Depend On Sex, Marisa J. Savini, Kylie M. King, Noelle M. Molnar, Evelynn J. Schneider, Savannah E. Straub, Joe Parker, Lillianna P. Puppel, Aleece K. Al-Olimat, Allison M. Bach, Andrew Jones, Phillip R. Zoladz

ONU Student Research Colloquium

Single treatments with psychedelics have demonstrated rapid, long-lasting antidepressant effects. However, psychedelics often produce unfavorable psychoactive effects that could worsen existing psychological distress. Thus, we compared the effects of psilocybin and the related tryptamine, norbaeocystin, on anxiety-like behavior in male and female rats. In Experiment 1, rats were treated with 1 mg/kg psilocybin (PSIL), 1 mg/kg norbaeocystin (NOR), or vehicle 30 min before a 5-min trial on an elevated plus maze (EPM) or in an open field test (OFT). On the EPM, PSIL led to decreased open arm time and fewer arm entries in males and females. NOR led to …

Abstract Book (Pdf), Lsu Health School Of Medicine

Medicine Research Day

No abstract provided.

Smartphone Use, Social Media, And Academic Procrastination In Secondary Education: A Multi Method Approach Investigation With Implications For School-Based Interventions, Haslee Sharil Lim Abdullah, Riza Amalia, Henny Indreswari, Im Hambali, Ronal Surya Aditya, Rusnila Rusnila

Buletin Konseling Inovatif

Academic procrastination has become a significant challenge in digital learning environments, particularly among adolescents with high smartphone and social media usage. This study examines the relationship between mobile phone use and academic procrastination among 262 high school students in Indonesia using a cross-sectional survey, narrative review, and network analysis. Results show 75.6% of students exhibit medium and 20.2% high procrastination levels, with "alternative activities" like digital distractions as the main form (M = 15.87, SD = 2.92). No significant differences were found by gender (p = .067) or age (p = .412), but strong positive correlations emerged between gadget use …

Disruption Of The Lrrk2 Substrate Rab12 Facilitates Neurotransmission And Causes Hyperactivity In Mice, Xingjian Li, Yuanxin Chen, Huaixing Wang, Xue Zhang, Noah Guy Lewis Guiberson, Xianting Li, Jacqueline Burré, Junmin Peng, Hui Zhang, Zhenyu Yue

Department of Neuroscience Faculty Papers

RAB12 is a small GTPase and a validated substrate of LRRK2, a kinase genetically linked to Parkinson's disease (PD). While RAB12-LRRK2 signaling has been implicated in ciliogenesis and immune regulation, the neuronal function of RAB12 remains largely unexplored. Here, we investigated the role of RAB12 in synaptic physiology using Rab12 knockout (KO) mice. Rab12 KO mice developed normally but exhibited increased locomotor activity in adulthood. Electrophysiological recordings from striatal slices revealed enhanced presynaptic release probability and increased excitatory drive onto medium spiny neurons. Consistently, live-cell imaging of cultured cortical neurons revealed that Rab12 deletion facilitated, while Rab12 overexpression inhibited, synaptic …

Program And Proceedings, The Nebraska Academy Of Sciences 1880–2026: 146th Anniversary Year, One Hundred-Thirty-Sixth Annual Meeting

Nebraska Academy of Sciences: Programs and Proceedings

Program and abstracts of the proceedings for the Nebraska Academy of Sciences 136th annual meeting, 2025

Sessions

Aeronautics and Space Science

Anthropology

Biological and Medical Sciences

Earth Sciences

Ecology, Sustainability, and Environmental Science

Physics and Engineering

General Poster Session

2026 Maiben Lecture: Shifting Extremes: Understanding Nebraska’s Changing Climate and Preparing for What Lies Ahead, Deborah Bathke

2026 Friends of Science Awards: Julie Shaffer and Irina Filina

2026 C. Bertrand and Marian Othmer Schultz Colleaguate Schoalrship Award: Piper Ryschon and Bryce Reeson

In Memoriam: Paul Royster

Public Perception Of Equine Rabies And Its Implications For Future Education And Preventative Strategies, Kya Walton

Honors College Theses

This study examined the rabies knowledge, vaccination, and risks of exposures of horse owners/overseers across the state of Kentucky. Research was conducted to determine the need for public health educators and veterinarians to inform the public on rabies. Survey results concluded that respondents' general knowledge of rabies transmission and mortality rate was respectable, but knowledge relating to equine vaccination was comparatively lower. A weak inverse relationship was observed between general rabies knowledge and concern over an individual’s horses contracting rabies. A weak positive correlation was determined when looking into general rabies knowledge and the likelihood of vaccinating an individual’s horses. …

Ethnicity, Culture, And The Epidemiology Of Eating Disorders, Rebecca Atwell

Honors Theses

This systematic literature review addresses the research question: How does culture affect eating disorders? It examines the role of ethnicity and culture in shaping the prevalence, symptom presentation, and treatment of eating disorders across diverse populations. Although eating disorders have traditionally been studied in Western, predominantly White populations, growing evidence suggests that cultural norms, ethnic identity, globalization, and exposure to Western ideals significantly influence both the development and expression of disordered eating behaviors. Twenty peer-reviewed studies published between 2000 and 2024 were included. These studies were identified through systematic searches of PubMed, Scopus, Web of Science, and PsycINFO and selected …

The Implementation Of The Therapeutic Alliance In Aphasia Rehabilitation Research: A Narrative Review, Shelby Swiercz

Honors Theses

Background: The therapeutic alliance (TA), defined as the collaborative relationship between clinician and client, is widely recognized as a key factor influencing rehabilitation outcomes. However, within aphasia rehabilitation, its role remains underexplored and inconsistently measured

Methods: This narrative review examined peer-reviewed studies published between 1990 and 2025 that focused on adult aphasia rehabilitation and addressed the client-clinician relationship. Studies were identified through database searches, including PubMed, CINAHL, ComDisDome, EBSCO, and Google Scholar, and analyzed using thematic analysis.

Results: Most of the studies employed qualitative methodologies, particularly thematic analysis and semi-structured interviews, to explore patient and clinician perspectives. The therapeutic alliance …

How Pollinator Populations Can Impact Chronic Disease Risk, Kylee Cubbison

Honors Projects

This project investigates how pollinator populations can impact chronic disease risk. Pollinator populations are declining, which can have serious implications for human health. Declining pollinator populations can limit healthy food production and affordability. Poor nutrition is a major risk factor for most chronic diseases. Less healthy food available for people to consume can negatively impact diets and increase the risk of developing chronic diseases. This project aims to address a potential gap in research existing on this specific topic regarding pollinator populations and human chronic disease risk. A brochure targeted towards educating the general public on this topic was created …

Identifying Delays Impacting Maternal And Perinatal Deaths Using A Facility-Based Death Audit Review System Integrated With Community Engagement: A Mixed Methods Study, Zahid Memon, Wardah Ahmed, Shah Muhammad, Sajid Soofi, Shanti Chouhan, Arjumad Rizvi, Paul Barach, Zulfiqar A. Bhutta

College of Population Health Faculty Papers

BACKGROUND: Pakistan's persistently high maternal (178 per 100 000 livebirths) and neonatal (41 per 1000 livebirths) mortality ratios are compounded by lack of reliable data on the root causes and preventable risk factors, which hinders their effective use in improving care and progress toward safe, high-quality services. We sought to identify system delays impacting maternal and perinatal deaths using a facility-based death audit review system integrated with community engagement for implementing actionable solutions.

METHODS: We used a mixed methods, concurrent parallel study design at three secondary level healthcare facilities in District Matiari, Sindh, Pakistan. We reviewed 319 cases that included …

Nurse Education On Nonpharmacological Management Of Knee Osteoarthritis, Toyin Mary Ajayi

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project aims to fill the gaps in the management of knee osteoarthritis (OA) in adults aged 40 to 75 years in a primary care practice. Knee OA is a common chronic disease that significantly impacts pain, mobility, and quality of life. Although there is empirical evidence that nonpharmacological interventions, including exercise, weight control, and self-management education, are effective, these methods are not consistently used in clinical practice, and pharmacologic treatment continues to be used. The project was designed to inform healthcare personnel about evidence-based nonpharmacological strategies to improve patient outcomes and reduce reliance on …

Community-Based A1c Screening Initiative To Improve Diabetes Risk Identification Among People Experiencing Homelessness, Rebecca Drake, Deedee Long, Mariita Carter

Student Works

Abstract

Purpose: People experiencing homelessness (PEH) experience high rates of undiagnosed diabetes yet face significant barriers to preventive screening. This quality improvement project aimed to improve access to diabetes screening for PEH through on-site hemoglobin A1C (A1C) testing in a trusted community setting.

Methods: On-site A1C screening was implemented at the Utah County Food and Care Coalition (F&CC) using a low-barrier, community-based approach. Screening was conducted during routine service hours and integrated into existing workflows. Process, outcome, and balancing measures were used to evaluate feasibility, reach, and unintended effects.

Results: The intervention primarily supported identification of diabetes risk and referral …

Multifocal Papillary Thyroid Carcinoma With Ret P.V804m, Eml4-Alk Fusion, And Braf V600e Positivity, Jacob Beiriger, Leonard Estephan, Lubna Zuberi, Stacey Gargano, Elizabeth Cottrill

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Multifocal papillary thyroid cancer (PTC) can arise from independent primaries with discordant drivers in parallel clonal evolution rather than a single-clone pattern. We present a 31-year-old female with multifocal PTC harboring 3 distinct oncogenic alterations: a germline RET p.V804M mutation, low-frequency EML4-ALK fusion, and BRAF V600E mutation. The RET and ALK alterations were identified in a midpole nodule, whereas BRAF positivity was seen in a separate lower pole tumor. Ultrasound revealed multiple right-lobe thyroid nodules; the dominant 2.1-cm lesion was hypoechoic with calcifications. Fine needle aspiration revealed Bethesda III cytology, prompting thyroid lobectomy and an ipsilateral central neck dissection was …

Optimizing Costs & Efficiency With Heartcode Complete: A Quality Improvement Project, Jessica Bryant

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project aimed to implement HeartCode Complete (HCC), a simulation-based BLS training platform, at a 154-bed community hospital. The goal was to replace instructor-led BLS training, improve training efficiency, reduce costs, increase certification compliance, and enhance staff satisfaction.

BACKGROUND

Maintaining competency in CPR is a regulatory requirement for healthcare providers. Traditional instructor-led BLS training requires scheduled classes, instructor availability, and staff time away from clinical duties, contributing to certification delays and operational inefficiencies. Simulation-based training platforms offer self-directed learning with real-time feedback.

METHODOLOGY

This quality improvement project used Lean Six Sigma principles and Plan-Do-Study-Act cycles to guide …

An Evidence-Based Approach To Boosting Recovery In Endurance Runners, Sayla F. Rios

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to implement evidence-based recovery strategies among endurance runners. The project aims to decrease injury prevalence, improve recovery behaviors, and reduce perceived muscle soreness.

Background

Running-related injuries are common among endurance runners and are often associated with inadequate recovery. Evidence suggests that the use of recovery strategies may support muscle repair and reduce injury risk.

Methodology

This project used the Plan–Do–Study–Act framework to guide the implementation of strategies. 24 endurance runners participated in the project. Interventions included education and the implementation of recovery strategies, such as adequate protein intake, sleep optimization, self-myofascial …

Inhibition Of Cyclophilin D Rescues Cardiac Function And Bioenergetic Defects Caused By Neonatal Hypoxia, Jonathan R. Burris, Gisela Beutner, Min Yee, Bartholomew V. Simon, Michael F. Swartz, Kathryn B. Boudreau, Ethan D. Cohen, Chaitanya A. Kulkarni, Prottoy Hasan, Hongyue Wang, Karen L. De Mesy Bentley, György Hajnóczky, George M. Alfieris, Eric M. Small, Paul S. Brookes, Michael A. O'Reilly, George A. Porter

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Increased oxygen levels at birth regulate myocyte bioenergetic and structural maturation controlled by mitochondrial cyclophilin D (CypD). We evaluated mechanisms of neonatal hypoxic cardiac dysfunction by exposing neonatal mice to 12% oxygen and studied cardiac bioenergetics, myocyte maturation, and function. Hypoxia decreased the activity/assembly of electron transport chain complex I, uncoupled oxidative phosphorylation, increased proliferation, decreased differentiation, increased ventricular mass, and decreased cardiac function. CypD inhibition rescued most hypoxia-mediated effects and increased cardiac function. In conclusion, neonatal hypoxia alters cardiac bioenergetics, myocyte maturation, and cardiac function through CypD-dependent pathways, providing potential therapeutic targets for neonatal cardiac dysfunction.

Speed Of Intravenous Fluid On Glycocalyx Integrity And Central Blood Volume In A Porcine Septic Shock Model, Yosef Levenbrown, Md Jobayer Hossain, Paul T. Fawcett, Marjorie Postell, Anne M. Hesek, Lynell S. Jones, James P. Keith, Thomas H. Shaffer

Department of Pediatrics Faculty Papers

BACKGROUND: It is unclear whether the rate of intravenous fluid (IVF) administration in sepsis influences glycocalyx breakdown. This study aimed to measure the effect of rapid versus slow fluid bolus in a septic pig model on the integrity of the glycocalyx by measuring the serum levels of heparan sulfate and syndecan-1, breakdown products of the glycocalyx. Because endothelial glycocalyx is composed of apical cell membrane-bound proteoglycans such as syndecan-1, covalently bound with long linear glycosaminoglycans such as heparan sulfate, shedding of these different glycocalyx components is closely related. Additionally, we measured central blood volume (blood volume in the heart and …

How Mindfulness And Yoga Practices Are Implemented In Occupational Therapy, Madeline Roberts

Honors Theses

The application of yoga and mindfulness-based interventions (MBIs) in occupational therapy (OT) and their effects on occupational, cognitive, emotional, and physical outcomes are examined in this literature review. Occupational therapy is a comprehensive, client-based field that helps people engage in everyday activities to improve overall well-being, health, and independence. In recent years, there has been an increased interest in using mindfulness-based interventions in occupational therapy, as they align with OT's focus on well-being and quality of life. A systematic literature search was conducted using PubMed, WMU Library Search, and ScienceDirect to identify peer-reviewed research on mindfulness-based interventions, yoga, and occupational …

Hospital-Acquired Pressure Injury Prevention Using A Care Bundle In A Neuroscience Intensive Care Unit, Sarah Dolick

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement DNP project was to implement a preventative care bundle to reduce the number of hospital-acquired pressure injuries.Compliance with bundle elements was monitored through weekly bedside audits. HAPI data were collected for 12 weeks pre-intervention and 12 weeks post-intervention to evaluate outcomes. The project utilized Plan-Do-Study-Act (PDSA) cycles to refine implementation and address barriers in real time.

Background: The project was implemented in a 32-bed neuroscience intensive care unit in an academic center in the Texas Medical Center.

Results: After implementation of the care bundle, average HAPIs decreased from 4.6 per survey (pre-intervention) to …