Methods To Reduce Recurrent Pregnancy Loss: An Integrative Review, Jolene J. Davis

All Electronic Theses and Dissertations

This integrative review explores interventions that may improve live birth rates or pregnancy outcomes for individuals experiencing recurrent pregnancy loss (RPL). Approximately 5% of couples experience RPL, and limited evidence contributes to inconsistent clinical recommendations for this population. A literature search was conducted using CINAHL, PubMed, and Nursing and Allied Health Collection. Inclusion criteria consisted of primary research studies published in English from 2016 to 2026 that evaluated preventative interventions aimed at improving live birth rates or pregnancy outcomes in individuals with RPL. Exclusion criteria included infertility unrelated to RPL, single miscarriage, animal subjects, in vitro fertilization-related studies, or studies …

Improving Nurse Confidence And Patient Safety Through Timely Nonpharmacologic Delirium Prevention Interventions: A Quality Improvement Project, Claire E. Mccabe

Master's Theses and Capstones

Abstract

Background

Delirium prevention is an ongoing patient safety priority within a Medical Intensive Care Unit (MICU) because delirium contributes to preventable patient harm, including unplanned device removal, prolonged mechanical ventilation, falls, increased mortality, and long-term cognitive impairment. Key signs of delirium include fluctuating awareness, severe confusion, disorganized thinking, and difficulty focusing. Although the ABCDEF bundle is established within the local MICU, an implementation gap remained in consistently integrating nonpharmacologic prevention strategies into routine nursing workflows.

Methods

The purpose of this quality improvement project was to improve nurse confidence, awareness of workflow opportunities, and implementation of evidence-based delirium prevention interventions …

Poorly Controlled Type 2 Diabetes (T2dm) In A Rural County In Texas: A Diabetes Intervention Bundle, Roxanne Morales

Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) remains a significant public health concern, particularly in rural and underserved communities where patients often face barriers to effective self-management. This quality improvement (QI) project evaluated the impact of a diabetes intervention bundle consisting of individualized diabetes education, biweekly support phone calls, and digital self-monitoring tools on glycemic control, body weight, diabetes knowledge, medication adherence, diet compliance, and physical activity. The project was implemented over an eight-week period in a rural family medicine clinic and included 18 adults with uncontrolled T2DM (HgbA1c >7%). Participant outcomes were evaluated using pre- and post-intervention clinical measures, the Diabetes …

The Effects Of Strong Parental Support And Societal Support Compared To Low Or Absent Support In Lgbtqia+ Youth, Kassandra Bautista

Nursing | Senior Theses

Background: LGBTQIA+ youth with unsupportive backgrounds face negative outcomes in their mental health. Past studies share that LGBTQIA+ youth have increased symptoms of mental illness including depression, anxiety, and suicidal thoughts and behaviors related to unsupportive environments among parents, peers, and society. Objective: By advocating for this minority group through education and culturally competent care, healthcare providers can reduce negative outcomes in the mental and physical well-being of the youth. Purpose: The purpose of this study is to address the impact of parental and societal support in LGBTQIA+ mental health, and to implement interventions and increase awareness of this issue. …

Comparing Nurse-Led Holistic Pain Relief Strategies And Sole Pharmacological Use In Enhancing Maternal Satisfaction, Reducing Pain, And Lowering Obstetric Interventions During Childbirth, Jessica C. Moore

Nursing | Senior Theses

Background: Childbirth has become heavily reliant on pharmacological management and obstetric interventions such as epidural use, labor induction, and cesarean deliveries (C-sections) even among low-risk pregnancies. While necessary in some cases, excessive reliance on pharmacological interventions can negatively impact the experience of birthing as a whole. Non-pharmacological interventions (NPIs) such as breathing techniques, positioning, hydrotherapy, massage, aromatherapy and continuous support have shown to be effective in reducing pain and supporting physiologic labor. The gaps in education and lack of standard implementation result in inconsistent application in practice. Purpose: This research proposal aims to evaluate the effectiveness of nurse-led NPIs compared …

How Social Media And Cyberbullying Correlate To Eating Disorders In Adolescents, Nicoli A. Panelo

Nursing | Senior Theses

Background: Social media is very prevalent in today’s society, particularly in adolescents. This time period is crucial for this age group in terms of developing a sense of purpose and identity. Although social media may keep many of our children entertained, they also can create negative impacts on them and ultimately hinder their overall development both mentally and physically through negative body image and unrealistic self-expectations. Purpose: The purpose of this study is to find the correlation between social media use and the rise of eating disorders in adolescents. Doing so would allow us to find ways to lower the …

Supporting New Graduate Nurses: Residency, Mindfulness, And Simulation, Shaianne Kaye S. Intal

Nursing | Senior Theses

The purpose of this research proposal is to examine the effectiveness of support systems in helping new graduate nurses bridge the potential gap between nursing education and clinical practice. It aims to address the inconsistencies in nursing education and clinical practice, and how these strategies can better support new graduate nurses. This study will focus on new graduate nurses within their first 2 years of practice in an inpatient setting. A mixed-methods convergent parallel design approach will be used by combining quantitative questionnaires with qualitative interviews at the same time. This will evaluate the effectiveness of nurse residency programs, mindfulness-based …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Senior Theses

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

Blister Packaging Versus Bottles: Caregiver Accuracy And Child Safety In Pediatric Medication Gummy Administration, Paolo Olimpiada

Nursing | Senior Theses

The safety of medication in pediatric settings has become an increasing concern as gummy-formulated medications have gained popularity in children’s care. Gummy-formulated medications have a close resemblance to candy, and this may mislead children to ingest additional doses or more than what was prescribed. Children also depend a lot on their caregivers for medications. Therefore, the design of packaging would be impactful in supporting medication dosing accuracy. And studies have evaluated safety features of packaging related to adherence, misuse, and unintended administration. However, limited studies have examined the influence of medication packaging on the dosing accuracy at the time of …

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

Honors Theses and Capstones

Introduction: Nursing education prepares students to care for patient populations by enhancing knowledge of clinical pathophysiology and applying foundational nursing skills to tailor to the unique care requirements of each patient. When analyzing the nursing course curriculums as guides for what is included in nursing education, it is essential to consider relevant patient populations to ensure adequate representation in lectures. Inclusivity of relevant patient populations within curriculums equips students to encounter a variety of patients in a clinical setting. Perinatal substance use has prevalence in the local community of this university, with 6% of all births in New Hampshire in …

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Voice Your Choice, Sarah Olson, Mercy Bustamante-Vizarretea, Hannah Bauman, Sally Hall

SPARK Symposium Presentations

Our proposal seeks to develop and implement a standardized Charge Nurse Interest Survey which will create a structured process for identifying those most interested and best suited for the position of charge for all registered nurses on a local med-surg unit. Nurses on this unit are appointed and eligible to serve in the charge nurse role after six months of experience on the unit. Research shows that charge nurses who demonstrate emotional stability, composure under pressure, strong organizational skills, and proactive planning contribute to improved team functioning and decreased workplace strain (Gottlieb & Gøtzsche-Astrup, 2018).

To clarify the charge nurse …

The Role Of Mentorship In Reducing Burnout In New Nurses And Nursing Students, Omari Andry

Honors College Theses

Burnout among new nurses and nursing students is a consistent issue affecting the healthcare system by adding to early career turnover, emotional exhaustion, and decreased quality of patient care. Structured mentorship programs have emerged as a promising intervention to alleviate burnout by giving emotional support, professional development, and coping strategies. This proposal explores the role of mentorship in reducing burnout symptoms, improving job satisfaction, and promoting emotional resilience among new nurses and nursing students alike. Based on existing scholarly articles, the project will investigate how structured versus informal mentorship affects burnout rates, the qualities of effective mentors, and the outcomes …

Short Time, Lasting Impact: Teaching Pediatric End-Of-Life Care In One Day, Mckenzie Taliaferro

Honors College Theses

Background: Pediatric nurses working in specialties that experience terminal diagnoses, death, and post-mortem care, often feel unprepared for the emotional toll and lack adequate support systems (Camera et al., 2024). Nurses report feeling under prepared due to a lack of hands-on opportunities before graduation (Richoux, et al., 2022). Pediatric death is a traumatic experience for families and nurses. Previous studies have shown that hands-on education increases nurses' confidence in caring for patients at the end of their lives (Cole & Foito, 2019; Noyes et al., 2023). Method: A one-day, hands-on multidisciplinary workshop on pediatric end-of-life (EOL) was created and offered …

Bias In Nursing Students: How Student Exposure Impacts Patient Interactions, Claire Roy

Honors Theses and Capstones

Bias is a pervasive issue in healthcare. It affects all aspects of the healthcare system and affects patients primarily through their interactions with healthcare providers. This study aimed to identify if exposure to various patient populations reduced bias among participants and increased their understanding of the way bias impacts patients. Two participants were recruited from a baccalaureate nursing program course titled “Living with Mental Illness” to participate in a series of two-semi structured interviews to identify bias, perceptions of community-based care, and the growth from the beginning to the end of their clinical experiences. Results showed skill development, increased understanding …

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Fear Of Childbirth As A Perinatal Comorbidity: An Integrative Review, Michelle T. Mcmanus, Ashely N. Payne

All Electronic Theses and Dissertations

Fear of childbirth (FOC) and tokophobia have a significant impact on one in every five pregnant women and is associated with enhanced levels of anxiety, depression, pre-traumatic stress, and has led to increased requests for elective cesarean sections. Given the influence that it has on birth mode and perceived birth experience as well as postpartum wellbeing, it stands to reason that FOC represents an often-overlooked aspect of perinatal mental health.
This capstone reviews cohort, cross-sectional, randomized, and quasi-experimental studies examining prevalence, correlations, and consequences of FOC. It evaluates antenatal education, midwife-led support, and cognitive behavioral therapy as potential interventions. Outcomes …

Gestational Diabetes Mellitus And Its Psychological Impacts During Pregnancy And Postpartum, Nehemie B. Hypolite, Charline Fast

All Electronic Theses and Dissertations

Introduction: This review explores the link between gestational diabetes (GDM) and psychological outcomes. GDM affects 8–10% of pregnancies and is typically diagnosed at 24–28 weeks. This burden leads to anxiety, depression, and fear. Postpartum concerns often persist for mother and infant.

Methods: Whittemore and Knafl’s (2005) method was used to synthesize data. The research databases included CINAHL and PubMed. Covidence supported screening and PRISMA diagram development. Key search terms included “anxiety and GDM,” “depression and GDM,” “GDM and postpartum depression,” “gestational diabetes,” and “pregnancy.” Inclusion criteria included full-text articles published after 2010, original studies, patients undergoing diabetic treatment (medication and/or …

The Impact Of Patient-Centered Care On Women With Infertility And Pregnancy Loss: An Integrative Review, Kaidynce R. Sweazy

All Electronic Theses and Dissertations

Introduction: Infertility affects roughly 17.5% of adults worldwide, while pregnancy loss occurs in up to 30% of pregnancies. These reproductive traumas increase the risk of developing a mental health disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD). The purpose of this review is to identify the influence of patient-centered care on psychological outcomes and experiences of care in women with infertility and pregnancy loss.
Methods: A literature search of the PubMed and Cinahl databases was conducted for original studies published from January 2016 to January 2026 that address the psychological outcomes and/or experiences of women who experienced infertility …

The Placenta & Covid-19: Histological Changes & Clinical Implications, Melissa F. Paul, Allyson J. Zadlo Sensor

All Electronic Theses and Dissertations

Introduction: The COVID-19 pandemic presented the medical community with complex and novel challenges, not the least of which is how to optimize prenatal and postnatal care for pregnant individuals who have been infected. At present, seven years have elapsed, and despite definitive research demonstrating adverse outcomes associated with placental changes, no professional consensus has been reached.
Methods: This integrative review includes studies involving pregnant individuals with confirmed SARS-CoV-2 infection, who recovered during the same pregnancy, and their infants. An examination of the data available reveals a triad of placental pathologies (chronic histiocytic intervillositis, perivillous fibrin deposition, and trophoblast necrosis) that …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

Master's Theses or Doctor of Nursing Practice

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Eeg Signatures Of Motor Development In Early Childhood: A Systematic Review, Sonia Khurana, Ashwini Kulkarni, Thomas C. Bulea, Hunter J. Bennett

Rehabilitation Sciences Faculty Publications

Background

Early identification of motor developmental disorders is limited due to lack of objective neural markers that characterize typical neurodevelopmental patterns. This systematic review interprets and synthesizes existing evidence to propose a framework of EEG signatures associated with motor development in children aged 0-5 years, which may help inform future benchmarks for early assessment and intervention.

Methods

Following PRISMA guidelines, we searched published and gray literature across five databases between 2000 and 2025 (registered protocol). Included studies examined EEG during task-based, resting-state, or sleep studies linked to motor milestones, task performance, or standardized motor assessments. Study quality was assessed using …

Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Student Research Posters

No abstract provided.

Increasing Colorectal Cancer Screening Rates At A Federally Qualified Health Center: A Quality Improvement Project, Kaeli H. Mcphee

DNP Scholarly Projects

Abstract 

Background: Colorectal cancer (CRC) is on the rise and is currently the second leading cause of cancer-related death in the United States (Wender, 2022). CRC screening rates are below national goals, particularly among underserved populations. At Lowell Community Health Center (LCHC), only 41.9% of eligible adults were up to date with CRC screening as of 2024.

Purpose: This quality improvement project aimed to increase CRC screening rates among average-risk adults aged 45 to 75 by implementing a multifaceted, low-burden intervention targeting both provider and patient behaviors.

Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, the intervention included: (1) provider and …

Moving Forward Together For Cancer Recovery: Collaborative Guide For Researchers And Cancer Care Organizations, M. Madison Kindred, Karen E. Wickersham, Daneille E. Ostendorf, Bernardine M. Pinto

Faculty Publications

No abstract provided.

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Reducing 30-Day Readmission Rates In Patients With Heart Failure, Charles Mccoy

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Globally, heart failure affects approximately 54 million individuals and has reached pandemic levels, contributing to elevated 30-day readmission rates (Sa et al., 2024). Background: In the United States, 30-day readmission rates range from 18% to 20%, with similar rates across all states. The current rate was documented as 29% at the study setting hospital. Objective: Implement a Quality Improvement project based on education, evidence-based order sets, and referral to palliative care to reduce 30-day readmission rates among adults with heart failure. Methods: Nursing staff completed education specific to heart failure, and patients received the American Heart Association Self-Check assessment. …

Ask, Advise, And Act: A Smoking Cessation Bundle For Cancer Patients, Crystal Tencate

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Smoking is the number one cause of preventable illness and death in the United States. For patients undergoing cancer treatment, continued tobacco use poses serious risks. In surgical oncology, smoking is associated with poorer treatment outcomes, increased postoperative complications, delayed wound healing, and higher mortality. For patients requiring reconstructive surgery, smoking-related complications can be devastating, sometimes resulting in significant wound complications or loss of the reconstruction. Despite these well-established risks, smoking cessation interventions are not consistently integrated into clinical practice.

To address this gap, a quality improvement project was implemented to strengthen smoking cessation efforts among advanced practice providers (APPs) …

Improving Asthma Management In Schools: A Comprehensive Approach To Education, Environmental Enhancements And Asthma Action Plans, Yesenia Trevino

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Asthma contributes to school absenteeism, especially in underserved communities. This project aimed to enhance asthma management at a South Texas elementary school through staff and student education, monthly air filter changes, and personalized Asthma Action Plans (AAPs).

Methods

A quality improvement project at a South Texas elementary school involved 40 asthmatic students over eight weeks, using the Plan-Do-Study-Act (PDSA) framework. It included staff and student education, air filter maintenance, and facilitation of Asthma Action Plans (AAPs). Pre/post surveys, custodial logs, AAP audits, and attendance were analyzed, with paired t-tests used to assess changes (N=32).

Results

There was 71.9% …