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Association Of Self-Efficacy, Preceptor Teaching, And Role Modeling With Practice Preparedness In Student Nurse Practitioners, Quinton Carroll, Pi-Ming Yeh, Jean Croce Hemphill, Melessia Webb, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

Purpose: Final-semester student nurse practitioners (SNPs) often report unpreparedness for practice. Little is known about which preceptor characteristics prepare students for practice. The purpose of this study was to examine whether final-semester SNPs' practice preparedness is associated with their self-efficacy and most significant preceptor’s clinical teaching effectiveness and role modeling.

Aim: To identify which student and preceptor factors are associated with and predict SNP preparedness.

Methods: Cross-sectional correlational study of final-semester SNPs (N = 83). Participants completed the New Nurse Practitioners’ Practice Preparedness Survey, New General Self-Efficacy Scale, Cleveland Clinic Teaching Effectiveness Instrument, and Role Model Apperception Tool. Analysis …

A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga

Research Collection School of Social Sciences

Who profits from the commodification of care and how does such accumulation occur? Focusing on the case of the nursing care market, this paper shows how professional schools and local hospitals within source nations like the Philippines profit from nurses seeking the credentials to qualify for jobs overseas. While existing studies show how nursing skills are exploited and undervalued, this paper argues that it is the process of skilling itself that allows for the accumulation of profit, regardless of whether nurses leave their origin countries to work abroad. This study reveals how global care economies are tightly linked to local …

Prevalence Of Fall Among Elderly In Rural Sabah And Its Associated Factors, Khalid Mokti, Mohd. Yusof Ibrahim, Syed Sharizman Abd Rahim, Mohammad Saffree Jeffree, Mazlinda Musa, Mohd. Rohaizat Hassan, Yugo Shobugawa, Muhammad Aklil Abd Rahim, Ahmad Faizal Roslan, Mervynn Koon Kar-Wai

Jurnal Keperawatan Indonesia

Falls are a leading cause of injury among older adults, often resulting in significant physical, psychological, and social consequences. This study aims to determine the factors that contribute significantly to fall risks among the older adults in rural Sabah. A cross-sectional community study was conducted in the Kudat Division, Sabah, Malaysia from January to June 2021. Using multistage random sampling, 700 adults aged ≥60 years were recruited, excluding those with severe disability, mental illness, or institutionalized. Data were collected through face-to-face interviews with a structured questionnaire adapted from the validated Japanese Gerontological Evaluation Study (JAGES) tool, and anthropometric measures were …

Hybrid Diabetes Coaching Model: Integrating In-Person And Telemedicine Strategies To Improve Glycemic Outcomes, Sandis A. Mundackal

Student Scholarly Projects

Practice Problem: In patients with type 2 diabetes, poor glycemic control among adults remains a significant challenge in primary care settings, particularly within federally qualified health centers (FQHCs) that serve underserved populations. At the FQHC practice site, patients were managed using standard care with quarterly follow- up visits, without a structured hybrid coaching approach. This inconsistency contributed to a high number of patients with hemoglobin A1c (HgbA1c) levels ≥ 9%, placing them at increased risk for diabetes-related complications.

PICOT Question: In adults with poorly controlled type 2 diabetes (HgbA1c ≥ 9%) (P), does monthly hybrid coaching delivered through in-person and/or …

Marital Satisfaction And Social Media Use: A Comparative Study Based On Addiction Levels, Fatma Ayhan, Elif Arık, Merve Gülsüm Saçan, Zehra Sevim, Esme Arguç

Makara Human Behavior Studies in Asia

In recent years, the widespread use of social media platforms has raised questions about their impact on marital relationships. This study examined the relationship between marital satisfaction, social media use, and certain sociodemographic characteristics. This descriptive and cross-sectional study comprised 461 individuals residing in Turkey who had been married for at least one year. Data were collected using the Bergen Social Media Addiction and Marital Satisfaction Scales. Statistical analyses included t-tests, analysis of variance, and multiple linear regression analysis. Social media addiction was high among 16.5% of the participants. Marital satisfaction was higher among males, those who married at age …

A Nurse-Led Staff Education Program To Prevent And Detect Elder Abuse By Caregivers In The Home, Nicola Violet Brown-Walters

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a nurse-led, evidence-based staff education initiative designed to improve the prevention and detection of elder abuse in the home by caregivers within an outpatient primary care setting. Elder abuse places older adults at risk for physical harm, neglect, medication mismanagement, and violations of autonomy and patient rights. Elder abuse remains a pervasive and underrecognized problem in nursing practice, often resulting from limited staff education, inconsistent screening practices, and uncertainty regarding mandatory reporting requirements. The practice-focused question examined whether implementing a nurse-led targeted education program guided by the ADDIE instructional design model and …

Staff Education To Reduce The Incidence Of Bias In Managing Patients With Opioid Use Disorder In A Rehabilitation Center, Almarie Alison Mclaren

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed stigma and implicit bias toward individuals with opioid use disorder (OUD) within a rehabilitation subacute care setting. OUD remains a significant public health concern and at the project site, inconsistent staff education was identified as a practice gap requiring intervention. The purpose of this practice-focused DNP project was to evaluate the impact of a structured staff education intervention on healthcare staff knowledge, attitudes, and confidence in caring for patients with OUD. The project was guided by a thorough evidence search. The project was implemented using brief, unit-based educational sessions delivered to interdisciplinary …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Nature-Based Approaches To Dementia, Cognitive Impairment, And Caregiver Well-Being: A Scoping Review Of Gardening And Therapeutic Strategies, Mary Dioise Ramos, Marcy Purnell, Jolie Harris, Gloria Giarratano

School of Nursing Faculty Publications

Background: Dementia is a growing global health concern, with behavioral and psychological symptoms (BPSD) contributing significantly to diminished quality of life and caregiver burden. Non-pharmacological interventions, such as gardening and nature-based therapies, are increasingly recognized for their therapeutic potential. Objectives: This scoping review aimed to: (1) map existing evidence on gardening and garden-based interventions for individuals with dementia; (2) assess impacts on caregivers; (3) identify mechanisms of benefit; and (4) summarize effective design and implementation strategies. Methods: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five databases. Studies were screened using Covidence. Inclusion criteria …

Impact Of Dialysis On Medication Pharmacokinetics, Rachel Marie Bounds

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education initiative to improve nurses’ knowledge and comfort with dialysis-specific medication management. The project addressed a practice gap in which nurses at the clinical site had limited knowledge of medication administration for patients with end-stage renal disease. These patients have altered pharmacokinetics and high medication burden, which increases the risk of adverse drug events. Inappropriate management of medications during dialysis can lead to hypotension, ineffective treatment, and glucose instability, making this a critical nursing practice issue. The project answered the practice-focused question of whether a structured educational intervention would improve nurses’ knowledge and comfort …

Implementation Of A Turn Team To Reduce Hospital-Acquired Pressure Injuries In A Medical Intensive Care Unit, Heather A, Adair

Doctor of Nursing Practice Final Project Abstract

Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

PURPOSE

The project aimed to reduce hospital-acquired pressure injury (HAPI) rates in a Medical Intensive Care Unit (MICU) by improving nurses' knowledge of the Braden Scale and implementing a structured two-nurse turn team workflow to reposition high-risk patients every two hours.

RESULTS

Repositioning compliance improved substantially and consistently exceeded the project goal of 90% after implementing a pod-based workflow. The HAPI prevalence rate decreased from a baseline of 8% to below the project goal of ≤5% during implementation but was not sustained in the …

Transitional Care Model Telehealth Calls To Improve Hospital Follow-Ups In A Community Health Center: A Quality Improvement Project, Veronica Dejesus

DNP Projects

Title: Transitional Care Telehealth Calls to Improve Hospital Follow-Up in a Community Health Center: A Quality Improvement Project

Background/Introduction: Transitions from hospital to primary care are a vulnerable period associated with missed follow-up appointments, poor patient outcomes, and increased readmissions, particularly in underserved populations. Internal data identified gaps in timely post-discharge follow-up, while external evidence supports structured transitional care interventions, such as telephone outreach within 48–72 hours, to improve patient engagement and continuity of care.

Objective/Purpose: The purpose of this quality improvement project was to evaluate whether structured, nurse-led transitional care telehealth calls improve completion of primary care follow-up visits …

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Expanding The Boundaries Of Bedside Practice: Transport Nursing As A Living Model Of Clinical Nurse Specialist Competencies, Ian A. Lane

Faculty Publications (Peer-Reviewed)

Objectives: The purpose of this paper is to argue that clinical nurse specialist (CNS) education represents the most conceptually and professionally continuous advanced practice pathway for critical care transport nurses, and to highlight transport nursing as an underrecognized practice context that aligns closely with CNS competencies and warrants deliberate attention from CNS educators and programs.

Description:  This paper presents a conceptual analysis of transport nursing through the CNS spheres of influence, emphasizing continuity with bedside nursing expertise while extending into quality improvement and systems leadership. This perspective examines how transport nurses routinely navigate high-acuity clinical cases and interfacility system constraints. …

To Treat Or Not To Treat: Evaluating Antipyretic Use And Patient Outcomes In Febrile Care, Nico Teodosio, Brynley Harris

Williams Honors College, Honors Research Projects

This honors project aims to critically examine the evidence-based practice use of antipyretics in fever management, questioning whether suppressing fever is truly in the patient's best interests and if it benefits patient outcomes. Grounded in nursing, past nursing courses, and emerging research, this project aims to answer the following PICOT question: In febrile patients, how does withholding, or not administering, antipyretics compared to administering antipyretics affect patient outcomes during hospitalization? Through a literature review, this project will analyze studies from databases like PubMed and Google Scholar, focusing on outcomes like recovery time, symptom severity, complications, and mortality. Using the PRISMA …

How Does The Frequency Of Visits Impact The Quality Of Life For Nursing Home Residents?, Sophie M. Carlton

Honors Undergraduate Theses

This integrative literature review examines the relationship between quantity of visitation and quality of life (QOL) of nursing home residents. The purpose of this review is to examine existing research to determine whether an optimal “dosage” of visitation exists that meaningfully enhances QOL for this vulnerable population. Establishing an evidence based- guideline may help reduce uncertainty for families and promote more consistent improvements in resident well-being. Nursing home residents are the focus of this work because their limited ability to leave the facility makes visitation one of their primary sources of non-occupational social interaction. The COVID19 pandemic further heightened the …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

Non-Pharmacological Sleep Interventions For Dementia Caregivers: A Systematic Review Of Randomized Controlled Trials, Aisling Smyth, Lambert, Mark Jenkins, Adugnaw Zeleke Alem, Misganaw Gebrie Worku, Sujatha Shanmugasundaram

Research outputs 2022 to 2026

Background: Caregivers of people living with dementia frequently report poor sleep. This systematic review describes evidence from randomised controlled trials of non-pharmacological sleep interventions for dementia carers. Methods: A systematic search of major databases was undertaken. Risk of bias was assessed using the Cochrane ROB 2.0 tool. Narrative synthesis followed Synthesis Without Meta-analysis (SWiM) guidelines due to substantial heterogeneity. Findings: Eighteen articles were included. Risk of Bias analyses revealed most studies had high overall risk of bias, primarily from selection of reported result bias. Interventions comprised of five categories: sleep-promoting, carer well-being, exercise, technology-based and complementary therapy. High variability between …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

Barriers To Mental Healthcare In Rural Agricultural Communities, Monica Salonga

Research Honors

Mental health diagnoses have become increasingly concerning in the United States (US). In 2024, 60 million adults in the United States experienced a mental illness, and over 14 million adults stated they had suicidal thoughts (Reinert et al., 2025). The Center for Disease Control (CDC) reports around 4,000 suicide-related deaths in the United States every year (CDC, 2025). One population that suffers from disproportionate rates of suicide is farmers and farm families. Farmers are ranked #4 in the United States regarding suicide rates (Miller & Rudolphi, 2022). Between 2003 and 2018, there were 1,935 suicide-related deaths committed by farmers (Miller …

The Experience Of Homelessness Among Older Adults In Bhutan - A Narrative Inquiry Study, Phuntsho Om

Theses: Doctorates and Masters

A shift in the demographics of homelessness started to occur in the 1900s, with a significant increase in the number of middle-aged or elderly men and women being recognised as a part of the homeless population. The rising urgent global concern of homelessness of older adults necessitates a deeper understanding of the lived experience and holistic well-being of these marginalised adults. This thesis aimed to explore the phenomenon of homelessness of older adults in Bhutan, which is an often neglected topic in both national and international gerontological research.

Employing narrative inquiry within the constructivist approach as articulated by Pino Gravidia …

From Fear To Familiar: Decreasing Technology Anxiety Among Older Adults In A Senior Community, Regina Rayz

Master's Projects and Capstones

Objective: Older adults (defined by the WHO as those 65 and older in developed countries) are more susceptible to technophobia than younger adults (Song et al., 2025). The fear and anxiety occurs with use of smartphones, tablets, social media, and telehealth and is associated with higher rates of social isolation and reduced autonomy. Technology-use anxiety is a preventative obstacle that inhibits both technology acceptance as well as overall health (Kim et al., 2023). Aim: To reduce technology-related anxiety among older low-income adults living in a senior residential facility in Richmond, CA by at least 25% using a brief, individualized technology …

Charting The Course: Improving Psychotropic Medication Documentation Through Staff Education To Promote Patient Safety And Cms Compliance, Anne J. Bertram Rn

Master's Projects and Capstones

The University of San Francisco master’s level nursing program culminates with a clinical nurse leader (CNL) quality improvement project. The objective of this project is to reinforce the program’s didactic CNL classes by allowing students the opportunity to design, implement, and analyze a quality improvement project in a microsystem. SETTING: Skilled nursing facilities often prescribe psychotropic medications to help manage residents’ behavioral and psychological symptoms. Due to the possibility of side effects and increased sedation, there are concerns for patient safety and quality of life. Inadequate management of these patients and symptoms compromises patient safety and breaches state and federal …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Faith Community Nursing: Home Care Delivery Model, Deborah J. Ziebarth

International Journal of Faith Community Nursing

Faith community nurses (FCNs) perform home visits as part of their scope of practice. The FCN does home visits based solely on the assessed needs of patients, regardless of insurance or prescriber orders. A historical review describes the practice gap leading to the development of the Faith Community Nursing: Home Care Delivery Model provided in the booklet: Visitation Guidelines for Faith Community Nurses. Through a review of literature, alignment, and diagram, key components are defined. A wholistic screening exemplary (Congestive Heart Failure) is shared. The model’s key components are screening/assessment for specific disease risk (pre-diagnosed and diagnosed), education (patient and …

Quality Improvement Project: Development And Implementation Of A Structured Certification Support Program And The Impact On Nurses’ Confidence And Medical Surgical Certification Rates, Mary Tran

Doctor of Nursing Practice Projects

Professional nursing certification is an important criterion of Magnet designation, and increased certification rates have been associated with positive patient outcomes. The literature supports peer support and group study as beneficial strategies to assist nurses in preparing for certification exams. A quality improvement project among medical-surgical (med-surg) nurses at a community hospital pursuing Magnet redesignation addressed the lack of formal processes and nursing perceived barriers to certification that may contribute to low certification rates. The purpose of this project was to develop and implement a structured medical-surgical certification support program following the Plan-Do-Study-Act (PDSA) cycle utilizing evidence-based strategies, including a …

The Artful Aging Project, Maria Carmelita Fernandez, Sah'neya Fryer, Kathleen Morris, Maya Price

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

As the older adult population in Sacramento County continues to expand, addressing age-related declines in fine motor function, cognition, and social well-being has become increasingly critical. Such declines can compromise activities of daily living, reduce independence, and exacerbate risks associated with social isolation. Evidence suggests that art-based interventions may mitigate these effects by enhancing motor coordination, promoting social engagement, and stimulating cognitive processes. The Artful Aging Project was designed to evaluate the effectiveness of structured art activities in improving fine motor skills and social wellness among older adults served by the Stanford Settlement Neighborhood Center (SSNC). Grounded in community-based participatory …

Quality Improvement Project: Effect Of Multi-Level Student Collaboration On Clinical Judgment In High-Fidelity Simulation, Jillian Carroll

Doctor of Nursing Practice Projects

There is a gap in undergraduate nursing curriculum on incorporating collaboration and communication into patient care, leading to a lack of competence and confidence in novice practice. Using collaboration in high-fidelity simulation, students gain real-world exposure and opportunities to communicate and make independent decisions. Using Kotter’s eight-step change theory, this project addresses the limited exposure to collaboration by implementing purposeful interdisciplinary collaboration within high-fidelity simulation to improve undergraduate nursing students’ confidence and competence in nursing practice. This will build on Patricia Benner’s novice-to-expert theory and help advance Associate Degree Nursing (ADN) students into a safe and effective novice year of …