Digital Commons Network^™

Dexmedetomidine Versus Propofol For Reducing Emergence Delirium In Pediatric Anesthesia: A Scoping Review, Hannah Laxton Bsn, Rn, Hannah Mclain Bsn, Rn, Robert Mohr Bsn, Rn, Sarah Rocha Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Dwanye Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background 

Propofol is widely regarded as the standard anesthetic agent for preventing and treating emergence delirium, particularly in pediatric patients. Emergence delirium presents as postoperative agitation that may escalate to self-injurious behavior that can lead to disruption of critical lines or equipment. Since its approval in 1999, dexmedetomidine has gained attention for its sedative and sympatholytic properties, offering potential advantages over propofol. This study compares the postoperative effects of propofol and dexmedetomidine in reducing emergence delirium in pediatric surgical patients.

Methods 

A scoping review was conducted using PRISMA guidelines to identify relevant literature published between 2000 and 2025. Databases searched …

Optimizing Efficiency In Joint Injections In An Outpatient Orthopedic Oncology Clinic Using Lean Six Sigma, William Alexander Byrd

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Prolonged in-room wait time in an outpatient orthopedic oncology clinic was identified as an important driver of dissatisfaction and operational inefficiency. Baseline in-room times in this setting were reported as M=96.2 minutes for patients receiving injections and M=92.9 minutes for those not receiving injections. This quality improvement project used Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, Control) framework to streamline clinic workflow for the joint injection process. Over an eight-week period, four key interventions were introduced: a standardized order set for medications, pre-bundled supplies and portable supply toolbox, telephone pre-consenting of patients, and optimized scheduling of …

Quantification Of Illicit And Prescription Drug Residues In Pasteurized Donor Human Milk: A Comprehensive Analytical Approach, Michelle Brenner, Kaytlin Krutsch, Ashlynn Baker, Dhavalkumar Patel, Palika Datta

Department of Pediatrics Faculty Publications

Objective

To assess the risk of infant exposure to illicit and prescription drug residues, from infant-ready, pooled, pasteurized donor human milk (PDHM) provided by healthy, screened, voluntary non-remunerated donors to a not-for-profit milk bank.

Study Design

A total of 150 pooled samples, representing 742 donor contributions, were analyzed for 15 illicit and prescription drug analytes using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Detected concentrations were evaluated for clinical significance.

Result

All 150 PDHM samples tested negative for residues of marijuana, amphetamines, benzodiazepines, fentanyl, hydrocodone, and morphine. Three samples (2%) contained trace amounts of oxycodone (< 0.6 parts per billion), yielding exposures over 455 times lower than established standards for infant safety (Relative Infant Dose: < 0.022%; standard safety threshold 10%).

Conclusion

Comprehensive analysis detected no clinically …

Comparing The Evolution Of The Advanced Practice Nurse Role: Insights From Switzerland And Kenya, Carole Mackavey, Sara Kohler, Eunice Ndirangu, Rachel Kimani, Constance Shumba, Bernard Mutwiri, Colette Henderson, Anna Jones

School of Nursing & Midwifery, East Africa

The article explores the evolution of Advanced Practice Nurse (APN) roles in Switzerland and Kenya, highlighting their development, challenges, and influence on healthcare delivery. Despite notable differences in income levels and healthcare infrastructure, both countries are committed to strengthening primary care through the deployment of APNs. Switzerland uses APNs to address provider shortages and improve chronic disease management, whereas Kenya uses them to increase access in underserved areas. A comparative analysis explores how regulatory frameworks, educational models, scope of practice, and health system priorities influence the adoption of advanced practice nursing (APN). Switzerland’s established healthcare system supports the integration of …

Differences In Comorbidities, Presenting Symptoms, Demographics, And Patient Reported Outcomes In Long Covid By Initial Test Status, Stephanie Georgoudiou

Nursing Dissertations - Archive

Importance Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), remains a major global health concern. Recovery may result in persistent symptoms known as post-acute sequelae of SARS-CoV-2 (PASC), or long COVID. Most studies focus on individuals with laboratory-confirmed infection; however, some patients with COVID-like illness and negative tests also develop persistent symptoms. Testing status should not delay appropriate interventions or specialist referrals. Early, symptom-based care is essential to improve outcomes.

Objective To compare patient-reported outcomes and demographics between long COVID patients who tested positive versus negative during their initial illness.

Design, Setting, and Participants This secondary …

Music Interventions For Critically Ill Patients: Evaluating Effects Of Music On Psychoemotional Symptoms In Critically Ill Patients Receiving Respiratory Support, Allyson Crighton

Honors Undergraduate Theses

Critically ill adults receiving respiratory support in intensive care units (ICUs) frequently experience psychoemotional disturbances such as agitation, anxiety, and delirium, which contribute to prolonged ventilation, increased sedative use, and adverse patient outcomes. While pharmacologic management remains standard practice, associated risks including oversedation and delirium highlight the need for safe, complementary interventions. Emerging evidence suggests that music-based interventions may offer a non-invasive, cost-effective strategy to reduce psychological or emotional distress in this vulnerable population. This integrative literature review examined the effects of music interventions, including passive music listening and structured music therapy, on agitation and related psychoemotional outcomes in critically …

Parenting Stress And Its Association With Parental Technoference: An Integrative Literature Review, Emily S. Machuca

Honors Undergraduate Theses

Introduction: Today, digital devices are a part of daily life, but can serve as a distraction that interrupts important relationships, a process referred to as technoference. In the context of parenting, device use during child interactions may reduce parental attentiveness and engagement, with potential implications for child development and behavior. Parenting stress may influence how and why parents engage with digital devices in the presence of their children. However, the association between parenting stress and parental technoference remains unclear in the current literature. This integrative literature review aimed to synthesize existing evidence examining the relationship between parenting stress and parental …

Examining The Effectiveness Of Icu Diaries In Reducing Post–Intensive Care Syndrome (Pics) Psychological Symptoms: A Rapid Review Of United States–Based Studies, Lananh Tran

Honors Undergraduate Theses

Background: The growing recognition of Post-Intensive Care Syndrome (PICS) has prompted investigation into interventions, such as ICU diaries, to mitigate the long-term psychological effects of PICS. Intensive care unit (ICU) diaries – journals written by clinicians and loved ones during an ICU admission – are a tool that can help patients reconstruct the events of their critical care experience. Entries in the diary may include clinical updates, explanation of treatments, and encouraging words from loved ones or staff. Previous research in European countries found ICU diaries may be effective in reducing psychological effects post ICU admission.

Research question: The aim …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

Attitudes Toward Dementia Among Nursing Students: A Cross-Sectional Study, Ngoc Ha Vo Thi, Thuy Nga Tran Thi, Ngoc Sen Hoang Thi

Health Professions Education

Purpose: Dementia is the loss of cognitive function, including thinking, memory, and communication, due to brain disorders. The global prevalence of dementia is increasing, affecting younger populations. Caring for individuals with dementia requires preparedness to manage behavioral and psychological symptoms. As future healthcare providers, nursing students are expected to have the necessary knowledge and attitudes to support dementia patients. To describe nursing students' attitudes toward dementia and explore related factors.

Methods: A cross-sectional study was conducted on 520 nursing students at Da Nang University of Medical Technology and Pharmacy. A structured questionnaire assessed demographic characteristics, academic information, knowledge, and attitudes …

Implementing A Change Process To Support Respectful Communication In Newborn Units In Kenya: A Qualitative Study, Mwanamvua Boga, Peris Musitia, Dorothy Oluoch, Dyuti Sen, Hiza Dayo, Ane Haaland, Lisa Hinton, Jacinta Nzinga, Mike English, Sassy Molyneux

Institute for Human Development, East Africa

Background: In contexts of high workloads, resource shortages, and environmental inadequacies, neonatal nurses in many low- and middle-income countries face high levels of stress and burnout, as well as significant communication challenges. Advancing care in these ‘on the edge’ emotionally fraught contexts requires a multi-layered systems approac:, including context-sensitive courses that support respectful communication.

Methods: We share our learning from the implementation of a communication and emotional competence training process in two public hospital newborn units in Kenya. We adapted an existing course in collaboration with newborn unit nurse managers, with the aim of enhancing relationships among staff and …

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 …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

Dnp Repository: Using Technology To Help Nurse Leaders Make A Global Impact, Cynthia Plonien, Cathy Brown, Vanessa Garrett

Nursing Faculty Publications & Presentations - Archive

No abstract provided.

Burnout And Workforce Outcomes Among Registered Nurses, Madeline Willcoxen

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationship between staffing and organizational support interventions and workforce outcomes among registered nurses providing direct patient care in hospital settings. The study focused on three measurable outcomes: emotional exhaustion, absenteeism, and annual nurse turnover. The population included hospital-based registered nurses, and the comparison involved standard staffing and support conditions.

Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2026 were identified using PubMed, CINAHL, Scopus, and PsycINFO databases. Inclusion criteria required quantitative studies examining staffing or organizational support interventions among registered nurses in …

Bridging The Gap: Human Trafficking Education Improves Nursing Students’ Knowledge And Confidence, Stephanie P. Arceneaux, Sharon Boudreaux

LHC Group • Myers School of Nursing

Background: Human trafficking (HT) is a global, national, and local public health concern, yet victims often go unidentified due to limited provider education and a lack of screening protocols. This quality improvement project implemented an asynchronous online HT education module for senior nursing students to enhance knowledge and confidence in identifying victims through recognition of red flags and use of screening questions. Method: The module addressed HT indicators, screening tools, screening questions, and available resources. Pre- and posttests using the PROTECT instrument assessed perceived knowledge, actual knowledge, and confidence. Results: Postintervention scores showed statistically significant improvement (p < .001) in knowledge and confidence. Only 10.67% of participants had prior HT training, and 52% preferred online, asynchronous learning. Conclusion: HT education …

Caught In The Midwife’S Hands: A Black Feminist Exploration Of Reproductive Health And Justice In Massachusetts, Nina Bakum

Gender, Sexuality, and Intersectionality Studies Honors Papers

No abstract provided.

Exploring Dominican University Nursing Students’ Perceptions Of Economic Barriers To Accessing Essential Women’S Health Products, Annabelle E. Burke

Nursing | Senior Theses

Period poverty is defined as inconsistent or inadequate access to feminine hygiene products, and it has been shown to negatively impact physical and mental health, academic performance, and dignity across diverse populations. Existing research highlights financial strain, social stigma, and insufficient support as key barriers to menstrual equity among individuals experiencing homelessness, adolescents living in low-resource environments, low-income women, and general undergraduate students (Brinkley & Niebuhr, 2023; Dave et al., 2022; Gruer et al., 2021; Lahme et al., 2018; Parkinson et al., 2024; Gilchrist et al., 2024). However, no studies have examined these issues amongst Dominican University nursing students who …

Paternal Involvement And Bonding In Neonatal Intensive Care Unit: Evaluating Daily Caregiving, Emotional Well-Being, And Father-Infant Connection, Ava G. Kinyon

Nursing | Senior Theses

Background: Premature birth and serious neonatal conditions frequently require infants to obtain care in the NICU, producing psychological and emotional obstacles for families. Despite the fact that skin-to-skin contact has been extensively researched for its strengths in encouraging stability and bonding, there persists restricted importance and understanding on paternal participation in routine caregiving tasks such as feeding, diapering, temperature checks, and swaddling. Purpose: This study aims to evaluate paternal participation in daily NICU caregiving tasks to address gaps in comprehending how these experiences impact bonding and emotional well-being among fathers of hospitalized infants. Methods: This study will employ a quasi-experimental …

The Impact Of Home Birth Integration On Maternal-Neonatal Outcomes And Patient Satisfaction: An Integrative Review, Mary E. Hillaker, Jennifer K. Jacobitz

All Electronic Theses and Dissertations

Introduction: Home birth is a safe option for low-risk populations. As awareness of home birth increases, so do the families choosing home birth. Governing bodies recommend well integrated maternal health systems, yet the impact of level of integration on perinatal outcomes and patient satisfaction has not been specifically examined. The purpose of this integrative review is to identify the impact home birth integration has on maternal and neonatal outcomes, patient satisfaction, and how communities can improve their integration level.
Methods: A keyword search of current literature was conducted using CINAHL, PubMed, and Scopus databases. An additional hand search of 2 …

Dosage Considerations For Aspirin Therapy To Prevent Preeclampsia In Pregnancy, Melissa S. Haraway

All Electronic Theses and Dissertations

Introduction: Preeclampsia remains the leading cause of maternal and neonatal mortality worldwide despite extensive and ongoing research on the subject. The use of aspirin therapy to reduce preeclampsia in pregnancy is widely researched and accepted into practice, however, optimal dosing is still debated. The purpose of this review is to identify which dosage of aspirin therapy offers the most effective reduction in preeclampsia without increasing the risk of postpartum hemorrhage.
Methods: The following databases were searched using the framework methodology by Whittemore and Knafl: CINAHL, PubMed, ScienceDirect, Scopus, ProQuest, and Citations. The search criteria limited articles to five years old …

A Descriptive Study Of Cancer Care Experiences And Burden Of Rural South Dakotans, Sarah Mollman, Teddi Dowling, Patricia Woolridge, Jamie Hillmer, James Odom, Marie Bakitas, Hossein Moradi Rekabdarkolaee, Brandon Varilek

Journal Articles: College of Nursing

BACKGROUND: American Indian (AI) persons with advanced cancer (PwAC) in South Dakota have seen increased rates of cancer incidence and mortality compared to national rates. These inequities are driven by social determinants of health. Providing early palliative care is highly important for rural PwAC but is sparsely available in rural South Dakota.

OBJECTIVE: To explore cancer care experiences and patient symptoms and caregiver burden among AI and rural PwAC, and their family caregivers (FCGs), to understand the barriers and opportunities for adapting an early palliative care intervention.

DESIGN: Descriptive study design reporting on the qualitative and quantitative data collected.

METHODS: …

The Association Of Social Determinants Of Health On Mortality Among Adults With End-Stage Kidney Disease: A Systematic Review And Meta-Analysis, Prince Agyapong, Lauren Longacre, Patti Brooks, Hossein Moradi Rekabdarkolaee, Surachat Ngorsuraches, Aine O'Connor, Semhar Michael, Brandon Varilek

Journal Articles: College of Nursing

RATIONALE/OBJECTIVE:: Synthesize evidence from published studies on end-stage kidney disease (ESKD) mortality and determine associations between social determinants of health (SDOH) and ESKD mortality.

STUDY DESIGN:: This PRISMA-guided study examined all published research across four electronic databases.

STUDY POPULATIONS:: Adults with ESKD living in the United States.

SELECTION CRITERIA FOR STUDIES:: Clinical trials, observational, cross-sectional, and prospective/retrospective cohort studies were considered if one or more of the five domains of SDOH were present in the analysis.

EXTRACTION/ANALYSIS:: Extraction was performed independently by two reviewers using a standardized form that captured study purpose and design, outcomes, SDOH domain, setting, participant characteristics, …

Trauma And The Brain: Foundations To Trauma-Informed Care In Nursing, David Wolff

OER Materials

The goal of this presentation was to educated nursing students about what traumatic events are and how they impact a patient, thus informing their approach to nursing care that is trauma-informed.

Chronic Dislocations And Pain In A College Athlete, Rachel Joseph, Trina Walker, University Of Wisconsin - Madison, Rebecca Kronk, Karen J. Whitt, Deborah O. Himes

Faculty Publications and Presentations

This diagnostic case study describes an 18-year-old woman and competitive gymnast who presents with recurrent joint dislocations, chronic musculoskeletal pain, and dermatologic findings suggestive of a heritable connective tissue disorder. Early recognition of connective tissue disorders is essential for accurate diagnosis, genetic evaluation, injury prevention, and long-term management planning.

Treatment Manual For Nonsequential Format Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course), Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

This is the Treatment Manual and 5 Appendices for NonSequential Format.  Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

An Introduction For Nursing Research: An Open Educational Resource For The Undergraduate Nursing Student, Ellen Benjamin

OER Textbooks

The purpose of this text is not to prepare you to independently conduct research, but to help you become an informed and critical consumer of research. The ability to systematically evaluate the strengths, limitations, and applicability of research findings is known as critical appraisal. Critical appraisal is an expected competency of baccalaureate-prepared nurses [5] and requires a foundational understanding of research principles and methods. This book will introduce the research process, including common research methodologies, data collection and analysis approaches, ethical considerations, and strategies for translating research evidence into nursing practice.

Changes In Telehealth Usage Among Medicaid Beneficiaries With Mental Illnesses In A Rural State: An Analysis Of Kentucky Medicaid Dataset Over 5 Years (2018–2022), Chizimuzo T.C. Okoli, Tianyi Wang, Bassema Abufarsakh, Sarret Seng, Zainab Almogheer, Jarrah Al-Kayed, Pooja Bhattarai, Holly Stith, Andrew Makowski

Nursing Faculty Publications

Introduction: Accessing mental health care remains challenging for Medicaid beneficiaries with mental illnesses (MI) in rural settings. The COVID-19 pandemic prompted telehealth service expansion through temporary policy changes and shifts in health care delivery. Despite the increased availability of telehealth as a modality to address disparities in health care access, telehealth adoption and associated use are inadequately explored among Medicaid beneficiaries with MI in Kentucky.

Objective: To examine trends and factors associated with telehealth use by residence status among Kentucky Medicaid beneficiaries with MI.

Design: A retrospective analysis of Kentucky Medicaid claims data obtained from 174,354 beneficiaries aged 18 years …