Digital Commons Network^™

Examining Nurse Burnout During The Covid-19 Pandemic: Causes And Mitigation Strategies, Melanie Sena

Honors Projects

Nurse burnout is a multidimensional occupational syndrome that predates the COVID-19 pandemic, yet the pandemic served as a catalyst that intensified its scope and severity in ways that the healthcare system was profoundly ill-equipped to manage. Characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, burnout among nurses accelerated dramatically between 2020 and 2022 as clinical workloads surged, personal protective equipment remained scarce, and moral distress became a near-universal experience across care settings. This review examines the primary systemic and individual contributors to nurse burnout during COVID-19, explores the consequences of burnout for both nurses and patients, …

Implementing A Self-Administered Crafft Screening Tool In A Pediatric Mental Health Setting, Michael Nguyen

Doctoral Dissertations & Projects

Background: Adolescent substance use disorders (SUDs) require early identification in inpatient psychiatric settings, but inconsistent screening workflows limit systematic detection.

Aims: This quality improvement project evaluated implementation of the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) 2.1 screening tool to improve identification of adolescents at risk for SUDs and support multidisciplinary communication.

Methods: CRAFFT 2.1 screening was embedded into admission workflows for adolescents admitted to two inpatient psychiatric units. Admission nurses distributed self-administered forms during admission. Completed screenings were scored and entered into the electronic medical record. Scores were categorized as low (0), medium (1), or high (≥2). High-risk results …

Quality Improvement Project: Integrating Depression Screening Into Adult Wellness Visits In A Primary Care Clinic, Nina Denchukwu

Doctor of Nursing Practice Projects

Depression is a prevalent and debilitating mental health condition that remains significantly underdiagnosed in primary care, despite national recommendations for universal adult screening. At the project site, less than 40% of adults completing annual wellness visits had documented depression screening. The purpose of this quality improvement project was to evaluate whether integrating the evidence-based Patient Health Questionnaire (PHQ)-2 and PHQ-9 into the electronic health record (EHR) would improve completion of depression screening, documentation, and referrals to treatment. The project was guided by Rogers' Diffusion of Innovations Theory and the Plan-Do-Study-Act (PDSA) framework. A quantitative pre–post intervention design linked with the …

Quality Improvement Project: Impact Of Faculty Competency And Classroom Application Of Artificial Intelligence (Ai), Clydea Hale

Doctor of Nursing Practice Projects

The rapid integration of artificial intelligence (AI) in healthcare has created a growing need for nursing faculty to develop competency in AI to adequately prepare students for modern clinical practice. Despite this need, limited faculty knowledge and low classroom application of AI persist. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of an evidence-based AI educational intervention on nursing faculty competency and classroom application. Guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory, a quasi-experimental pretest-posttest design was implemented with nursing faculty at a rural community college in …

Promoting Trauma-Informed Practices Through Staff Education, Ediomi Enebong Oduwole

Doctor of Nursing Practice Projects

Front office staff in outpatient psychiatric settings are often the first point of contact for patients experiencing anxiety and emotional distress. However, existing evidence indicates that non-clinical, front office staff often lack formal training in trauma-informed care (TIC). This gap may limit early recognition and response to patient distress. This quality improvement project addressed this gap by evaluating the impact of a trauma-informed educational intervention of staff confidence and documentation of patient distress. The project was guided by Pender’s Health Promotion Model and Lewin’s Change Theory. It used a pre-and post-intervention quantitative design with sample of five front office staff …

Understanding Adult Patients’ Experiences Of Trauma-Informed Care In Outpatient Healthcare, Jayme Aguero

Dissertations (1934 -)

Trauma is recognized as a universal human experience. Well-established evidence demonstrates the negative impact of trauma on health outcomes. In 2014, following a recommendation from SAMHSA, trauma-informed care (TIC) was implemented across human service sectors, including healthcare. While TIC has been in use for the past decade, adults’ experiences of receiving TIC in outpatient healthcare remain largely unknown. The purposes of this study were (a) to explore and describe how adults’ healthcare experiences aligned with the principles of TIC being implemented in outpatient healthcare settings and (b) to understand the perceived usefulness and meaning of TIC for adult patients. A …

Quality Improvement Project: Improving Adn Faculty Professional Development Through Simulation Training, Sharon Haley Peace

Doctor of Nursing Practice Projects

Lack of structured simulation training for nursing faculty, which has been identified as a gap in the literature, can negatively impact the quality of simulation-based education and student learning outcomes. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to develop, implement, and evaluate an evidence-based training intervention aimed at improving faculty self-efficacy and competence in simulation facilitation. The project was guided by Lewin’s Change Theory and Kolb’s Experiential Learning Theory to support faculty development. A quantitative, quasi-experimental pre-post design was used with a convenience sample of nine associate degree nursing faculty at a rural community …

Quality Improvement Project: Improving Provider Workflow And Documentation For Routine Mental Health Screening In An Outpatient Psychiatric Clinic, Sharon Uchechi Joshua

Doctor of Nursing Practice Projects

Depression and anxiety are leading causes of disability and are frequently underdiagnosed in outpatient psychiatric settings due to inconsistent screening and documentation practices. Evidence supports the use of standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to improve early detection and clinical outcomes. This quality improvement (QI) project evaluated whether implementing standardized electronic health record (EHR) templates and provider education would improve documentation of PHQ-9 and GAD-7 screenings. The aim was to increase the consistency of screening and documentation among psychiatric providers. The project was guided by the Plan-Do-Study-Act (PDSA) framework and Lewin’s Change …

Embedding Social Determinants Of Health Into Maternal Simulation Scenarios: Enhancing Nursing Staff Awareness Of Equity-Based Education, Sherina Evans

Doctor of Nursing Practice Projects

Despite growing evidence emphasizing the importance in addressing disparities in maternal health outcomes, maternal health simulations often lack integration of social determinants of health (SDOH) and cultural considerations. The purpose of this Doctor of Nursing Practice quality improvement project was to enhance nursing faculty cultural awareness through simulation scenarios that incorporate SDOH and culturally responsive elements. This project was guided by Lewin’s Change Theory and the Jeffries Simulation Framework. The aim was to strengthen faculty awareness and skills to support the development of culturally inclusive simulation experiences. Descriptive statistics were utilized to analyze results which was a limitation. Nursing faculty …

Improving Monitoring And Documentation Of Long-Acting Injectable Antipsychotic Adherence In Patients With Schizophrenia Through Staff Education And Refill History Review, Stacy Ann Bruce

Doctor of Nursing Practice Projects

Schizophrenia is a chronic psychiatric disorder associated with relapse, hospitalization, and poor outcomes when medication adherence is suboptimal. Nonadherence increases morbidity and healthcare utilization (World Health Organization, 2022; Zhao et al., 2025). Long-acting injectable (LAI) antipsychotics improve adherence and reduce hospitalization, but inconsistent monitoring and documentation in outpatient settings hinder early identification of missed doses (Lieslehto et al., 2022). This Doctor of Nursing Practice (DNP) quality improvement project aimed to evaluate whether staff education and structured refill-monitoring processes improve identification and documentation of nonadherence to LAI antipsychotics. Using Kotter’s Change Management Model and the Plan-Do-Study-Act framework, the project focused on …

Quality Improvement Project: Emergency Preparedness In Urgent Care: Impacting Competency Among Medical Assistants, Sarah Pettyjohn

Doctor of Nursing Practice Projects

Urgent care settings present significant challenges, including limited staffing and resources, unpredictable patient acuity, and training deficiencies. These factors contribute to a competency gap among medical assistants, limiting their ability to recognize and respond to medical emergencies. The purpose of this quality improvement project is to impact emergency medical preparedness through a formal educational intervention. Grounded in Lewin’s Change Model and the Kirkpatrick Model, the project aims to improve emergency medical competency, consistent with evidence supporting structured training approaches. Using American Heart Association guidelines, medical assistants participated in a six-week educational program implemented through the Plan-Do-Study-Act framework, with assessments administered …

Improving Identification And Referral Of Xylazine‑Associated Wounds In Homeless Healthcare, Ramon A. Gambino

Doctor of Nursing Practice Scholarly Projects

Background: Xylazine-adulterated fentanyl is linked to distinctive necrotic wounds and complex care needs in unsheltered populations. This quality improvement (QI) project implemented a brief survey and referral log at Albuquerque Health Care for the Homeless (AHCH) to track suspected xylazine-associated wounds and referrals to advanced care. Methods: Final data were exported from Qualtrics, cleaned to retain finished responses, standardized categories, and de-identified. The analytic sample included 18 encounters. Results: Results showed that 55.6% (n = 10) documented suspected xylazine-associated wounds; 5.6% (n = 1) reported no suspicion; 38.9% (n = 7) were uncertain. Referrals were rarely documented overall at AHCH …

Improving Cultural Competence Among Healthcare Professionals Through A Targeted Staff Training Program, Oyindamola Akinkugbe

Doctor of Nursing Practice Projects

Limited culturally competent care for Hispanic patients worsens existing health disparities, creates misunderstandings, leads to poor health outcomes, and reduces satisfaction with the quality of care. In an outpatient clinic, more than 70% of patients are Hispanic, yet healthcare providers reported a lack of confidence in caring for culturally diverse patients. Extensive literature supports staff training to improve provider cultural competence, but implementation remains inconsistent across healthcare settings. This quality improvement project addressed this gap by implementing a targeted staff training program grounded in the Culturally and Linguistically Appropriate Services (CLAS) in Nursing framework. The purpose of this project was …

Enhancing Shared Decision-Making In Mental Health Care: A Quality Improvement Initiative, Joanna L. Hysler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is an evidence-based approach that enhances patient engagement, treatment adherence, and clinical outcomes in psychiatric care. Despite strong support in the literature, SDM remains inconsistently implemented in mental health settings due to limited provider training, time constraints, and organizational barriers. The purpose of this Doctor of Nursing Practice quality improvement project was to implement and evaluate an educational intervention designed to improve SDM utilization and provider confidence within a private outpatient psychiatric practice. The project was guided primarily by the Plan-Do-Study-Act framework to support structured practice change, with Lewin’s Change Theory providing additional conceptual support. The intervention …

Quality Improvement Project: Reimplementation Of Bedside Reporting, Veronicah Banga

Doctor of Nursing Practice Projects

Communication breakdown during nursing shift handoffs is a major patient safety challenge in healthcare today. At the project site, 85% of handovers occurred at the central nursing station, and most staff nurses expressed dissatisfaction with the quality of the bedside reporting. In psychiatric nursing, unique barriers exist that make bedside reporting challenging, including patient confidentiality and an individual's diagnosis. Such barriers eroded bedside reporting (BSR) over time, leading to measurable safety risks and nursing dissatisfaction. The purpose of this quality improvement project was to reintroduce bedside handoffs using the Situation, Background, Assessment, and Recommendation (SBAR) framework and to maintain BSR …

Organizational Governance Capacity And Organizational Resilience In Hospitals: A Cross-Sectional Study, Leyla Afşar, Selim Yazıcı

Makara Journal of Health Research

Background: This study aims to examine the relationship between organizational governance capacity (OGC) and organizational resilience (OR) in hospitals, with a focus on cross-institutional differences.

Methods: A cross-sectional study was conducted among 1,143 employees from six hospital types in Istanbul, including university, Ministry of Health (state, training and research, and city), and private hospitals. Validated scales were used to measure OGC and OR. Data were analyzed using descriptive statistics, nonparametric tests, and structural equation modeling (SEM) to assess the relationships between these dimensions.

Results: Private hospitals demonstrated the highest levels of both OGC and OR (70%), followed …

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 …

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 …

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 …

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 …

Staff Education On Early Sepsis Recognition For Medical-Surgical Nurses In The Acute Care Setting, Nadine Nzenga Udom

Walden Dissertations and Doctoral Studies

In this staff education project, I targeted early sepsis recognition and response among medical-surgical nurses. The practice gap at the site was nurses’ limited knowledge of sepsis indicators and screening tools, which contributed to delayed escalation of care. The practice-focused question guiding the project was “Does educating medical-surgical nurses on early sepsis recognition and response improve knowledge of early sepsis recognition and response?” I applied the analysis, design, development, implementation, and evaluation (ADDIE) and Johns Hopkins Evidence-Based Practice (JHEBP) models to design a structured sepsis education program for nursing staff. I searched for peer-reviewed literature via databases accessed through the …

Staff Education To Improve Knowledge Of Evidence-Based Engagement Strategies To Reduce No-Show Rates, Jerrica Luster

Walden Dissertations and Doctoral Studies

High no-show rates in outpatient mental health settings remain a persistent barrier to effective care delivery, negatively affecting continuity of care, patient outcomes, and access to services. In the identified practice setting, inconsistent use of evidence-based engagement strategies beyond standard reminder practices contributed to missed appointments. The purpose of this Doctor of Nursing Practice project was to evaluate whether a structured staff education intervention on evidence-based engagement strategies would improve staff knowledge as a foundation for enhancing appointment adherence. A quantitative pre- and posttest design was used to evaluate knowledge change following the intervention. Participants included outpatient mental health clinic …

Gamification As A Strategy For Interprofessional Learning, Chisom S. Enebechi, Aislinn M. Dorko

Research & Creative Achievement Day

Background: A Community-based, student-led clinic provides free health services to underserved areas, bringing together students from allied health disciplines to promote interprofessional collaboration and health promotion. Previous orientation sessions were lecture-based with a team-building activity providing limited opportunities for active learning. To address this, a gamified orientation activity was developed using realistic, scenario-based cases designed to exemplify common community health situations. Purpose: This quality improvement project aims to evaluate whether gamification improves students' perceived ability to communicate, collaborate, and understand roles and responsibilities when delivering team-based care. Methods: The project was guided by Bandura's Social Learning Theory and implemented using …

Evaluating Mental Health Providers’ Knowledge And Attitudes Towards Stigma Among Teenagers Aged 13 To 19 Years With Mental Illness, Fredrica Murray Johnson

Wisdom & Compassion: The LUSON Journal

Limited knowledge and poor attitudes among mental health providers contribute to stigma towards individuals with mental illness, adversely affecting treatment experience and outcomes. This study evaluated the effectiveness of an educational intervention in improving mental health providers’ knowledge and attitudes toward stigma-based practices. The clinical question stated: Among mental health providers, does an educational intervention, compared to standard practice, improve knowledge and attitudes of stigma and promote evidence-based care delivery to adolescents aged 13 to 19 with mental illness within six weeks? The Iowa Model of Evidence-Based Practice (EBP) was the framework used to implement the quasi-experimental study. The two …

Non-Alcoholic Fatty Liver Disease, Diet And Contributing Factors: A Narrative Literature Review, Rachel Joseph, Ashley Tharpe, Sherri Ann Walker

Wisdom & Compassion: The LUSON Journal

Objectives: The purpose of this narrative literature review is to explore the relationship between Non-alcoholic fatty liver disease (NAFLD) and dietary habits, and identify factors that contribute to the development, progression, and potential management of NAFLD.

Methods: Search terms such as non-alcoholic fatty liver disease (NAFLD), diet, and nutrition, including plant-based and vegetarian diets, were used to identify 45 peer-reviewed publications published within the last five years.

Results: Dietary factors, biological, environmental, obesity, mental health, and genetic factors can contribute to the development of NAFLD. This multisystem problem can have economic, social, and psychological consequences that affect a person’s quality …

Resilience In Nursing Education: A Literature Review Examining The Experiences Of Ukrainian Nursing Students In The United States, Katherine Ferrell, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

The purpose of this literature review is to examine the experiences of international students who originate from war-torn areas, who live in the United States (US). Drawing from peer-reviewed sources, the review examines the academic, psychological, and social challenges these students face, including trauma, cultural adjustment, and gaps in institutional support. It highlights the resilience and coping strategies employed by students, as well as the role of universities in fostering inclusive environments. The review also identifies critical gaps in current research, particularly regarding long-term mental health outcomes and culturally responsive support services. This paper aims to synthesize existing literature on …

Navigating Life And Death: A Moral Critique Of Euthanasia Practices Worldwide, Brooke Fuzie, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

Euthanasia and physician-assisted death remain deeply debated ethical issues shaped by history, law, and cultural values. This narrative review explores how diverse ethical frameworks, shifting global legislation, and cultural perspectives inform current discourse, with special attention to the role of nurses guided by the American Nurses Association (ANA) Code of Ethics. Drawing on peer-reviewed studies, legal documents, and recent case analyses published between 2013 and 2025, the review identifies three key insights. Ethical frameworks influence whether society accepts or opposes euthanasia; robust legal safeguards are needed to protect autonomy and prevent misuse; and palliative care and advance care planning, including …

Perceived Knowledge, Attitude, Practice, And Barriers Of Jordanian Nursing Faculty To Integrate Genomic Concepts In The Curriculum: A Cross-Sectional Descriptive Study, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

Background: Rapid advances in genomics knowledge and the expansion of precision medicine have amplified expectations for nurses to integrate genomic concepts into education and clinical practice. Evidence regarding genomic knowledge, attitudes, practices, and barriers among nursing faculty in the Middle East is limited. To equip practicing and emerging nurses, faculty must be equipped. Faculty preparedness is critical to successful curriculum integration and to preparing future nurses for genomic-informed care.

Purpose: This study examined the perceived knowledge, attitudes, practices, and barriers related to integrating genomic concepts in the nursing curriculum among nursing faculty in Jordan.

Methods: A cross-sectional descriptive design was …

Volume 3, Issue 2 - Complete Issue

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Care, Capitalism, And Croissants: Interprofessional Students Take On Business Of Healthcare In Paris, Beth A. Komay, Phoebe S. Enebechi, Selma Dzamalija, Nicole A. Sharp

Research & Creative Achievement Day

The Business of Healthcare in Paris is a faculty-led study-away program that unites business, nursing, and other healthcare students in an immersive experience of global healthcare systems. The primary design of this course is around interprofessional learning that integrates coursework and cultural experiences from within the Midwest United States (US) and France. Students begin the course by visiting healthcare facilities and small alternative-therapy businesses in the US, gaining initial exposure to diverse care environments. They then travel to Paris and surrounding areas to explore comparable sites, including hospitals, an art therapy center, a residential rehabilitation facility, and small businesses providing …