Digital Commons Network^™

Improving Bedside Nurse Central Line Policy Compliance And Combating Clabsis, Keyshawna N. Chambers

Doctor of Nursing Practice Final Project Abstract

Central line-associated bloodstream infections (CLABSIs) are a problem, both globally and locally at this 20-bed pediatric cardiovascular ICU in Houston, TX. Bedside nursing staff had gaps in knowledge of central line policies and were often unaware of when dressings needed to be changed. This posed a significant concern, as this nosocomial infection is among the most life-threatening and costly complications in healthcare. Leadership attempted to correct this issue with weekly multidisciplinary rounds, but with high turnover, this was not a long-term fix. This quality improvement project aimed to increase central line policy compliance among bedside nursing staff to 93%, from …

The Use Of A Safety Screening Tool To Improve Sedation Holiday Compliance And Nurse Confidence, Shelby Marchisio

Doctor of Nursing Practice Final Project Abstract

Purpose

This project sought to evaluate the impact of a safety screening tool on sedation holiday compliance and nurse confidence.

Background

This project was conducted within a 42-bed intensive care unit at a large academic hospital in Houston, Texas. Despite having a nurse-led sedation holiday protocol, compliance averages varied from 50-85%. In alignment with evidence-based practice, it was determined that integrating a safety screening tool into the sedation holiday process may improve compliance.

Methodology

The FADE Model for Quality Improvement guided project development. An anonymous survey was conducted using Likert-scale ratings to assess nursing perceptions and confidence related to sedation …

Reduction Of Waste And Cost In A Cardiac Intensive Care Unit, Jincy C. Skaria

Doctor of Nursing Practice Final Project Abstract

Purpose:
To reduce medical supply waste and associated costs in a Cardiac ICU using a standardized supply cart system.
Background:
Pre-packed post-operative recovery kits were routinely opened for all admissions in the Cardiac ICU, resulting in disposal of unused supplies due to infection control and single-use policies. This practice contributed to avoidable waste, increased costs, and poor resource stewardship.
Methodology:
This quality improvement project was conducted in a 20-bed Cardiac ICU from September 28 to December 6, 2025. The intervention replaced routine opening of full recovery kits with selective retrieval of supplies by nurses from a standardized cart located outside …

Utilizing And Optimizing Forecasting Models For Nursing Demand: A Narrative Review, Kalpana Singh, Liyan Ajit D. Souza, Ananth Nazarene, Amane Mounia, Mahmoud Abdelwahab Khedr, Ahmad Mousa, Rebecca Rejo George, Abdulqadir J. Nahwan

Research outputs 2022 to 2026

Background: Accurately forecasting nursing demand is essential for effective workforce planning in the context of increasing patient volumes and the growing complexity of healthcare systems. Reliable forecasting supports optimal staffing, enhances patient care quality, and reduces operational risks. However, traditional forecasting approaches are increasingly challenged by evolving clinical demands, rising chronic disease burden, and rapid technological advancements. Aim: This narrative review aimed to (1) map existing models used for predicting nursing demand, (2) identify key predictive methodologies, data inputs, and evaluation metrics, and (3) highlight existing gaps and implications for healthcare policy and workforce management. Methods: A comprehensive narrative literature …

The Effect Of Midwife-Led Continuous Labor Support Care On Delivery Mode And Timely Initiation Of Breastfeeding In Primigravida Women In Northwest Ethiopia: A Hybrid Type I Implementation Study, Mengstu Melkamu Asaye, Aragaw, Eden Bishaw Taye, Kihinetu Gelaye Wudineh, Sara Bayes

Research outputs 2022 to 2026

Midwife-led continuous labor and childbirth support reduces the episiotomy rate and increases the rates of vaginal delivery and early initiation of breastfeeding. However, no studies have yet been conducted in Ethiopia. This study aimed to evaluate the effect of midwife-led continuous labor and childbirth support. A quasi-experimental study involving 419 primigravida women compared an intervention given by trained midwives at two hospitals to routine at two others. Data were collected from July to December 2024 through interviews and record reviews. The McNemar test was used to compare changes, with a p-value of less than 0.05. Midwife-led continuous labor support increased …

Global Trends In Bioterrorism And Biosecurity Research Publications (1997–2025): A Scopus Bibliometric Analysis, Festus Mulakoli, Samuel Gesaka, John Mbataru

School of Nursing & Midwifery, East Africa

Introduction: Bioterrorism and biosecurity preparedness are critical pillars of global public health protection and resilience of health systems worldwide. Although this field has grown over the past few decades, there remains limited clarity on how research efforts have evolved and where critical gaps persist, particularly regarding global collaboration and emerging biological threats. To address this, we conducted a bibliometric analysis to map publication trends, influential contributors, and collaboration networks in bioterrorism and biosecurity from 1997 to 2025. This study analyzed global research output, collaboration, and thematic evolution in bioterrorism and biosecurity and identified gaps relevant to preparedness and policy. …

Developing A Pediatric Pain Curriculum For Pediatric Anesthesia Fellows In Sub-Saharan Africa: A Delphi Study, Anisa Bhettay, Rebecca Gray, Romy Parker, Nikki Allorto, Abigail Amponsah, Brian Anderson, Lillian Baranzila, Charles Carapinha, Susan Carolus, O' Brien Kyololo

School of Nursing & Midwifery, East Africa

Background Comprehensive pain management in children requires a specialized skillset, with a limited number of clinicians possessing the level of expertise required to successfully navigate the complexities of holistic care. The emergence of pediatric anesthesia fellowship programs in sub-Saharan Africa presents an opportunity to embed a pediatric pain curriculum for trainees, improving the availability of specialist skill and knowledge in the field. Existing pain curricula fall short in addressing the sociocultural aspects of pediatric pain identified through research as being unique to the African context, and do not include elements of leadership and advocacy training required to navigate the complexities …

A Qualitative Socioecological Exploration Of Community Health Promoters’ Barriers And Facilitators In Cardiovascular Disease Prevention In Kenya, Emily Muchina, Maureen Akolo, Rose Maina

School of Nursing & Midwifery, East Africa

Background:

Cardiovascular diseases (CVDs) remain a growing public health challenge in low- and middle-income countries, where there is an upsurge of risk factors. Community health promoters (CHPs) have the potential to play a crucial role in CVD prevention and care to underserved communities in Kenya. However, there are limited studies on their experiences, which are likely shaped by multilevel barriers and facilitators across the individual CHP, the community, relationships with primary health systems, and societal-level policies and structures. This study explored the barriers and facilitators shaping CHPs’ experiences in mitigating CVD in Kenya.

Methods:

A qualitative descriptive study was conducted …

Implementing And Evaluating A Mental Health Education And Mindfulness Program For Police Officers, Patricia Lynn Young

Doctor of Nursing Practice

Background: Police officers are routinely exposed to occupational stress and trauma, contributing to an increased risk of anxiety, depression, substance misuse, and post-traumatic stress disorder (PTSD). Targeted mental health interventions are needed to proactively address their mental health. Purpose: This Doctor of Nursing Practice (DNP) project implemented and evaluated a mental health education and mindfulness program designed to reduce operational stress and increase knowledge and use of departmental mental health resources and mindfulness techniques among police officers. Methods: A pre–post intervention design was used over a 10-week period. Participants (n = 14) completed the Operational Police Stress Questionnaire (PSQ-Op) and …

Evaluation Of The Prevention And Management Of Assaultive Behaviors (Pmab) Training For Outpatient Ambulatory Care Staff, Michaela Bowles

Doctor of Nursing Practice

Background: Workplace violence (WPV) disproportionately affects healthcare workers and harms both staff well-being and the healthcare organization. Despite growing attention to WPV prevention, effective solutions remain limited. The purpose of this project was to evaluate the Prevention and Management of Assaultive Behaviors (PMAB) training in an outpatient ambulatory care setting and to assess staff’s confidence and ability to respond to escalating situations. Methods: A pre/post observational survey using Likert-scale, multiple choice, yes/no questions and narrative responses measured confidence before, immediately after, and 3 to 12 months following PMAB training. A retrospective review of WPV incident reports three months before and …

Mindbodystrong: A Pilot To Address Nursing Burnout & To Promote Wellness, Leilah Hunt

Doctor of Nursing Practice

Background: Nursing burnout rates have increased significantly since the Covid-19 pandemic, not only within the United States but throughout the world. As burnout is multifaceted in nature, identifying and addressing the root cause of burnout has been challenging. One approach to remedy burnout effects is by enhancing wellness through daily practice of healthy habits. Purpose: The purpose of this DNP project was to pilot and evaluate the effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on self-rated anxiety, stress, depressive symptoms, and burnout symptoms in a sample population of nurses at a large psychiatric hospital. This program has …

Measuring Provider Confidence In Using Long-Acting Injectable Antipsychotics In Hospitalized Adults With Schizophrenia Spectrum Disorders, Rachel Mccluskey

Doctor of Nursing Practice

Background: Schizophrenia spectrum disorders are severely disabling conditions requiring ongoing pharmacological management. Rates of medication nonadherence among individuals with schizophrenia spectrum disorder are high and strong evidence exists for the benefits of long-acting injectable antipsychotics (LAI) over oral antipsychotics. Despite this, only 10% of patients in Washington State with schizophrenia spectrum disorders are administered longacting injectable antipsychotics. Purpose: The purpose of this project was to measure change in provider’s confidence in prescribing LAI for hospitalized patients with schizophrenia spectrum disorders following one-on-one motivational information (MI) style informational/discussion sessions coupled with a prescribing reference. Methods: This quality improvement project surveyed provider’s …

Blink & Beat: Pupillometry Response In Autonomic Nervous System Monitoring, Ximena Castillo

2026 Spring Honors Capstones Projects

In the neuroscience intensive care unit (NSICU), nurses rely on advanced monitoring tools to detect neurological deterioration. Two noninvasive measures, heart rate variability (HRV) and pupillary light reflex (PLR), are used to assess autonomic nervous system function; however, it remains unclear whether these indicators provide overlapping or distinct information. The purpose of this observational prospective study is to evaluate the relationship between HRV and quantitative pupillometry measurements to determine whether these noninvasive indicators provide congruent information. Data already collected as routine care from NSICU patients is extracted from the medical record for analysis. Understanding the correlation between HRV and PLR …

Reducing Computed Tomography Delay In A High-Volume Emergency Department, Sarah Ouedraogo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Delays in computed tomography (CT) imaging contribute to prolonged emergency department (ED) length of stay and delayed clinical decision-making. At the project site, baseline data demonstrated an average ASAP CT order-to-scan time of approximately 116 minutes for non-critical ED patients, with CT readiness compliance rates of 0%. Gap analysis identified inconsistent patient preparation and fragmented communication between ED nursing and radiology as key contributors to avoidable delays. PICOT question: In non-emergent emergency department (ED) patients (P), how does the use of a CT readiness checklist by ED nurses (I), compared with no standardized readiness checklist (C), affect patient readiness …

Reducing Humpty Dumpty Syndrome In Pediatric Inpatients, Jeanene Burns

Electronic Theses and Dissertations

The Doctor of Nursing Practice project examined pediatric inpatient falls. The healthcare agency involved in the project identified concerns regarding pediatric inpatient falls. Data were collected on pediatric inpatient falls that occurred on two nursing units at this agency based on the Generalized Risk Assessment for Pediatric Inpatient Falls and the Humpty Dumpty Falls Prevention Scale. Results from the project indicated marginal statistical significance, with approximately a 60% reduction in falls after the implementation of the Humpty Dumpty Falls Prevention Scale. A recommendation for future research is a comparison of the two pediatric fall risk assessment tools after the Humpty …

Implementing Hypertension Guidelines Into Clinical Practice, Misti Michele Mays

Electronic Theses and Dissertations

Hypertension is a complex chronic disease process, and it is essential to educate the patient on the disease process, as well as on all aspects of self-management. It is essential that providers choose an evidence-based guideline by which they will manage their hypertensive patients. In addition, providers must schedule regular follow-up appointments with their patients, along with a wide variety of other multifactorial components in regard to the management of patients diagnosed with hypertension. In addition, providers have a responsibility to stay informed on new approaches to blood pressure management by reviewing the professional literature on a regular basis. Much …

Dna Methylation Of Slc6a4 And Nr3c1 In Term And Preterm Infants: A Pilot Study Of Nicu-Associated Stress, Kathryn J. Malin, Yvette P. Conley, Aleigha Barry, Rosemary White-Traut

College of Nursing Faculty Research and Publications

Background: Preterm infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU) are often exposed to early-life stress, which may contribute to long-term health consequences. Epigenetic markers, particularly DNA methylation (DNAm) of stress-related genes such as SLC6A4 and NR3C1, have been identified as potential biomarkers of early-life stress. Limited research has compared DNAm patterns between term and preterm infants or examined associations between NICU-related stress and DNAm in preterm populations. Objectives: This pilot study aimed to (1) compare DNAm patterns between preterm and term infants, (2) examine relationships between NICU-related stress and DNAm alterations in preterm infants, and …

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 …

Integrating Artificial Intelligence Into Fnp/Dnp Simulation To Enhance Clinical Competency, Doris K. Gonzales

SACAD: Scholarly Activities

Abstract  

This poster presents a theoretically grounded, AI-integrated simulation program design structured across 3-4 semesters of Family Nurse Practitioner (FNP) and Doctor of Nursing Practice (DNP) education. This program is designed to support the development of clinical judgment and diagnostic reasoning among FNP students. Guided by Tanner’s Clinical Judgment Model and Roy's Adaptive Model as Theoretical Framework. The program addresses identified gaps in differential diagnosis and role transition from Registered Nurse (RN) to FNP practice. A needs assessment informed the development of a semester-sequenced curricular framework integrating AI-supported simulation across four semesters. The proposed design illustrates how progressive simulation experiences …

The Predictive Ability Of Child Characteristics And Parenting Factors On Four Developmental Domains In Toddlers, Melly Latifah, Dwi Hastuti, Neti Hernawati, Reisi Nurdiani, Raihan Ainun Hasanah

Jurnal Keperawatan Indonesia

Stunting is a chronic condition that has a significant impact on child development. This phenomenon is primarily caused by prolonged nutritional deficiency, especially during the first 1,000 days of life. In addition, as family factors also play a crucial role in children’s development, this study aims to analyze the influence of child and family characteristics, mother–child attachment, parenting practices, and the nutritional status of children (stunted/non-stunted) on children’s gross motor, fine motor, language, and personal–social skills. This study used a quantitative design with an explanatory approach involving 202 mother–child pairs with children aged 12–36 months. The findings show that healthcare …

Educating Staff Nurses On Pain Reassessment, Katie Louise Pemberton

Walden Dissertations and Doctoral Studies

Pain is one of the most common reasons that patients seek medical care, and chronic pain is a major health problem. The goal of this project was to address a lack of current, evidence-based knowledge of nurses regarding pain reassessment. The context for this project was a medical-surgical area in a rural hospital. The Doctor of Nursing Practice project attempted to answer the practice focus question on whether education improved knowledge related to improving pain reassessment. The project framework utilized in the doctoral project was the analysis, design, development, implementation, and evaluation model. An education program was designed with the …

A Systematic Review Of Implementing Iot Healthcare Systems: Technological, Organizational, And Ethical Barriers In Rural Settings, Mudzramer A. Hayudini, Angela Joy A. Jimpoy, Jonel T. Alibasa, Aisha A. Carolino, Jenden M. Julkamri, Nagdir B. Muhadja, Al Rajab H. Aming, Hamdoni K. Pangandaman, John Ed Augustus A. Escorial

Jurnal Keperawatan Indonesia

The implementation of Internet of Things (IoT) technologies holds transformative potential for healthcare delivery in rural and underserved regions. This systematic review focuses on technological, organizational, and ethical barriers. A comprehensive literature search across six major academic databases yielded eleven empirical studies published between 2015 and 2025. The review adhered to PRISMA protocols, with data synthesized using the Synthesis Without Meta- Analysis (SWiM) guidelines. Findings revealed that technological challenges—such as unreliable internet connectivity, lack of device interoperability, and power supply issues—are widespread across rural implementations. Organizational limitations included inadequate training, resistance to workflow changes, and financial constraints. Ethical concerns primarily …

Factors Affecting Older Adult Adjustment At A Health Promoting Hospital In Nakhon Phanom, Thailand, Onuma Kaewkerd, Yuttachai Chaiyasit, Phensiri Dumrongpakapakorn, Nuttiya Prommasaka Na Sakonnakhon

Jurnal Keperawatan Indonesia

Elderly adjustment influences quality of life and well-being and informs appropriate health promotion, holistic care, and health services. This study aimed to investigate the factors influencing the adaptation of older adults by focusing on a study conducted at Dong Kwang Health Promoting Hospital in Nakhon Phanom Province, Thailand. A cross-sectional design was used for the study. The sample consisted of 100 older adults and were selected for data collection from March 22, 2023, to April 20, 2023. The research instruments consisted of questionnaires assessing personal information, spiritual well-being, stress, perceived self-care abilities of older adults, quality of life, and older …

Meet The Team: Exploring Health Professional Roles And Responsibilities In An Introductory Interprofessional Course, Elizabeth W. Blake, Kimberly A. Taylor, Beverly Baliko, Teri Browne, Donna D. Ray, Abbas Tavakoli Drph, Mph, Me

Publications

Introduction: Health professional academic programs require interprofessional education (IPE) to meet accreditation standards and better prepare students for collaborative patient care. The Interprofessional Education Collaborative (IPEC) includes the roles and responsibilities of the health professions as a key domain of IPE curricula. A learning module focusing on this domain was developed for an interprofessional introductory course involving 12 health professions. Adaptations to this module over time aimed to enhance content and student knowledge. Methods: Students were assigned to small interprofessional teams throughout the course and completed modules aligned with the IPEC core competencies. The first module highlighted roles and responsibilities. …

Effect Of The Senior Clinical Practicum On Baccalaureate Nursing Student Self-Efficacy, Allyson N. Mattingly

Graduate Theses, Dissertations, and Capstones

While nursing shortages are increasing and nurses are reporting higher rates of burnout and job-related stress, it is critical that educators in pre-licensure nursing programs identify strategies to better prepare novice nurses for entering the workforce. Using Bandura’s Social Cognitive Theory as a framework, this study sought to investigate whether a senior clinical practicum experience increases general and nursing competence self-efficacy, which may indicate better ability to cope in the face of adversity. This study was a quantitative one-group pretest-posttest design, investigating undergraduate Bachelor of Science in Nursing (BSN) students from accredited institutions in Kentucky. Results suggest that the clinical …

Staff Education To Improve Mental Health Staff Knowledge On Mobile Health Applications For Medication Adherence, Chipasha Chingwengwezi

Walden Dissertations and Doctoral Studies

Despite rising evidence supporting the efficacy of mobile health (mHealth) applications to enhance medication adherence among individuals with mental health conditions, there is little utilization of these applications within mental health facilities. This project aimed to address the issue of implementing an interactive education program to enhance the knowledge of mental health staff and skills in the application of mHealth apps to enhance medication adherence. The main objective of this project was to fill the gap between conducting research and implementing its outcomes by providing staff with the knowledge and skills to incorporate mHealth applications into their daily practice. The …

Nursing Students’ Attitudes About Correcting Health Misinformation On Social Media, Heather Ann Hill

Walden Dissertations and Doctoral Studies

Health misinformation on social media is a global public health concern. Research has shown that health misinformation causes significant harm in communities, especially for vulnerable populations with existing health disparities. Nurses have been urged to play a more significant role in combating health misinformation. Existing research has shown that nurses are hesitant to correct health misinformation on social media, but attitudes among current nursing students have not been examined. The purpose of this qualitative descriptive study was to explore nursing students' attitudes about correcting health misinformation on social media. Guided by Ajzen’s theory of planned behavior and Paterson and Zderad’s …

Transforming Nursing Clinical Education: The Power Of Environment, Student Motivation, And Clinical Instructors, Lia Mulyati, Nur Wulan, Abdal Rohim

Jurnal Keperawatan Indonesia

Clinical learning is an important component in the formation of nursing students’ professional competence. The clinical environment, student motivation, and the role of clinical instructors are factors that influence the achievement of learning outcomes in nursing clinical practice. However, the relationship between these factors is still not fully understood. This study aims to examine the relationship between the clinical environment, student motivation, and the role of clinical instructors, and to determine how these three factors contribute to learning outcomes in nursing clinical practice. A quantitative design with a cross-sectional survey approach was used. The sample consisted of 117 nursing students, …

Association Of Central Obesity And Hypertension In An Urban Area, Chandrayani Simanjorang, Diva Anita Churiana Sudrajat, Ulya Qoulan Karima

Jurnal Keperawatan Indonesia

Hypertension is one of the non-communicable diseases in Indonesia that is closely related to obesity. Therefore, this study aimed to determine the association between central obesity and hypertension in a cohort study group in Bogor City, West Java from 2011 to 2021. A retrospective cohort study design was employed, with multivariate Cox regression analysis performed using secondary data from the Risk Factors for Non-Communicable Diseases (FRPTM) Cohort Study. Among 3,586 samples, 879 incident cases of hypertension were observed by the end of follow-up, accounting for 24.5% of the at-risk population. The incidence rate of hypertension was 28 cases per 1000 …

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 …