Digital Commons Network^™

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.

Mixed Methods Studies Examining The Physical Activity Practices Among African American And Black Women: Protocol For A Methodological Scoping Review, Annette Moore Hubbell, Laura Killingsworth, Michele Shropshire

Faculty Publications - Mennonite College of Nursing

Background: African American and Black women are among the least physically active demographic groups in the United States and experience disproportionate burdens of chronic disease that may be reduced through regular physical activity (PA). Mixed methods research is increasingly used to examine the behavioral, social, and contextual factors that influence PA in this population.

Objective: This study aims to identify, examine, and describe the mixed methods designs used in research on PA practices among African American and Black women in the United States; compare methodological approaches; identify gaps in the literature; and provide recommendations for future research.

Methods: This scoping …

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 …

From The Goodness Of Our Hearts: A Scoping Review Of Qualitative Literature On Altruism As A Reward Mechanism For Nursing, Jacqueline Christianson, Madaline Mccarthy, Bonnie Sommers-Olson, Emily Horner, Norah L. Johnson

College of Nursing Faculty Research and Publications

Introduction

Altruism, the desire to help others, is a common motivation for choosing a career in nursing. Improved understanding of the role of altruism as a reward or motivation for currently-practicing nurses may inform future interventions to improve effort-reward balance among practicing nurses. Therefore, the purpose of this study was to collect, examine, and present literature on how altruism has been described as a reward mechanism or motivation for engaging in professional nursing.

Methods

This scoping review of literature used the Arksey & O’Malley method, PRISMA-ScR reporting checklist, and Rayyan review management platform. PubMed, Web of Science, and CINAHL were …

Beyond Numbers: Bridging Statistical Significance And Clinical Relevance In Healthcare Research, Maharaj Singh, Waheeda Khan, Mehreen Fatima

College of Nursing Faculty Research and Publications

Objective: This study aims to bridge the gap between statistical significance and clinical relevance using rigorous statistical methodologies applied to simulated healthcare data, thereby enhancing the translational value of research outcomes for patient‑centered care. Methods: A synthetic dataset representing 10,000 patients was generated, and descriptive statistics were applied to compare two treatment groups. Binary outcomes were predicted using both a logistic regression model and a neural network. Two‑tailed tests with a significant level of 0.05 were employed, utilizing SAS version 9.4 and IBM SPSS Statistics, Version 29.0 (IBM Corp., Armonk, New York, United States of America). Results: The simulated dataset …

Non-Pharmacological Interventions For The Management And Prevention Of Hypertensive Disorders In Pregnancy: A Review Of The Literature, Shenelle K. Smith, Laurena E. Lepp

All Electronic Theses and Dissertations

Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE), are a leading cause of maternal and perinatal morbidity and mortality worldwide. In the United States, rates of HDP continue to rise and are associated with preterm birth, fetal growth restriction, and long-term cardiovascular disease. Current management focuses only on low-dose aspirin for prevention. Surveillance and timely delivery remain the only definitive treatment for preeclampsia. This highlights a critical gap in prevention. Emerging evidence suggests that non-pharmacological interventions–particularly nutrition, physical activity, and lifestyle modification–may reduce the risk and severity of HDP. These approaches align with midwifery models of care emphasizing prevention, education, …

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 …

Elevated Bmi And The Effect On Breastfeeding Duration In Postpartum Individuals: An Integrative Review, Abigail E. Mobilia, Kirstin A. Wyly

All Electronic Theses and Dissertations

Introduction: It has been well documented that exclusive breastfeeding provides benefits for infants and postpartum individuals, yet rates remain suboptimal in the United States, particularly among those with elevated pre-pregnancy body mass index (BMI). Evidence suggests that elevated BMI is associated with shorter breastfeeding duration and may be influenced by physiologic, social, and structural factors. This integrative review synthesizes existing literature to clarify the relationship between elevated BMI and exclusive breastfeeding duration among postpartum individuals.
Methods: An integrative review was conducted following Whittemore and Knafl’s (2005) framework and PRISMA 2020 guidelines. A systematic search of PubMed, CINAHL, and Nursing & …

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 …

Increasing Mental Health Literacy In An African Immigrant Community In The United States, Dominic T. Nchamukong

Master's Theses or Doctor of Nursing Practice

Abstract

Introduction: The aim of this quality-improvement project was to assess the impact of an educational intervention on mental health literacy, attitudes, stigma, and help-seeking behaviors among members of an African immigrant community in Maryland.

Framework: The Health Belief Model (HBM) guided implementation of the project. The intervention was delivered using HBM constructs to promote increased mental health literacy.

Methods: The study was conducted in four phases: pre-project preparation, recruitment, educational intervention, and post-intervention evaluation. The six-week program was delivered both online and in person. Participants completed pre- and post-surveys measuring knowledge, attitudes, stigma, and willingness to seek professional mental …

Protecting Your Largest Organ: A Journey In Skin Cancer Education, Prevention, And Early Detection, Krista Schneider

Master's Theses or Doctor of Nursing Practice

Rates of skin cancer diagnoses continue to increase globally, making skin cancer one of the most commonly diagnosed malignancies. Despite rising incidence, many individuals lack knowledge of risk factors, warning signs, and effective prevention strategies. This quality improvement project aimed to improve skin cancer awareness by providing targeted skin cancer education to young adults enrolled at a university in the Midwestern United States. Conducted from August 18 to December 1, 2025, this project followed the Plan-Do-Study-Act framework. Educational presentations were delivered to students enrolled in freshman seminar courses over a two-day period, accompanied by distribution of digital flyers and pamphlets. …

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 …

Advanced Practice Workforce: ​Drivers Of Satisfaction & Retention​, Stephanie Bork, Amber Balzer, Sally Russell, R. K. Elswick Jr., Terry Jone, Kimberlee Ketchersid, Joseph Deranieri

School of Nursing Publications

Problem

The turnover of advanced practice registered nurses (APRNs) is costly for institutions and creates gaps in care for organizations. The aims of this study are to describe the characteristics of the APRN and PA workforce in a large, integrated academic medical center and examine relationships between APRN and PA workforce characteristics and organizational outcomes.

Background

APRNs encompass a diverse group of licensed clinicians and are integral to healthcare delivery. As APRNs roles expand to support healthcare needs, turnover is costly and adversely affects patient care. The APRN role remains constrained in many healthcare institutions, contributing to burnout and job …

Considerations For The Analysis Of Urinary Environmental Chemical Concentrations During Pregnancy, Danielle R. Stevens, Kaleigh Hinton, Katie M. O'Brien, Jessie P. Buckley, Barrett M. Welch, Jason A. Watts, Antonia M. Calafat, Julianne C. Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background:

Pregnancy physiology may impact indicators of hydration, affecting exposure assessment in gestational studies with urinary chemical biomarkers.

Methods:

We aimed to characterize hydration and demonstrate the impact of different methods for standardizing urinary chemical biomarker concentrations on exposure descriptives in the Human Placenta and Phthalates Study (n = 303, 2017-2020), a prospective pregnancy cohort with eight study visits between 12 and 38 weeks of gestation. We assessed trajectories and predictors of hydration using urine flow rate (UFR) and specific gravity (SG). Likewise, we examined trajectories and predictors of mono-n-butyl phthalate (MBP), for which concentrations were unstandardized or standardized via …

Feeding Mode Is Associated With Infant Night Sleep Trajectories During The First Postnatal Year, Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov, Corrie M. Whisner

Ellmer School of Nursing Faculty Publications

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, …

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 …

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.

Development Of An Educational Toolkit For Clinical Staff At Little Rivers Health Care To Guide Shared Decision Making For The Expanded Age Range Of The Hpv Vaccine, Maureen B. Boardman

DNP Scholarly Projects

BACKGROUND: The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States (CDC, 2024). Unlike other common STI's, persistent infection with HPV increases the risk of cancer. A Human Papillomavirus (HPV) vaccination was approved in the United States in 2006 for girls and women aged 9 to 26 and in 2009 it was approved for boys and men in this same age range. Despite 20 years of data on the efficacy and safety of the HPV vaccine, rates of completed HPV vaccine series remain low. In 2019 the Advisory Committee on Immunization Practices (ACIP) expanded …

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) …

Nursing Bundle To Improve Quality Metrics For Postoperative Patients, Kristine G. Coronado

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Postoperative pulmonary complications and inconsistent implementation of preventive nursing interventions remain significant challenges on acute care surgical units. The purpose of this quality improvement project was to reduce postoperative respiratory failure, hospital readmissions, and length of stay while improving nursing compliance with evidence-based interventions. A nursing care bundle, RISE—Respiratory therapy (structured, nurse-guided incentive spirometry), Incentivize movement (early ambulation), Sit up (head-of-bed elevation ≥30 degrees), and Eliminate germs (twice-daily oral care)—was implemented on an acute care surgical ward in South Texas. Nursing compliance with the preventative measures and patient outcomes were compared between pre- and post-implementation cohorts. Following implementation, nursing compliance …

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% …

Starting Strong: Improving Mmr Vaccination Rates In Kindergartners, Regina Bryan

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

During the 2023–2024 academic year, measles, mumps, and rubella (MMR) vaccination coverage among kindergarten students in this school district did not meet the Healthy People 2030 target, thereby elevating the risk of disease outbreaks. This quality improvement project aimed to improve MMR vaccination initiation and completion through coordinated, school-based interventions.

Methods

Guided by the Plan-Do-Study-Act framework, an eight-week immunization bundle was implemented across 14 elementary schools in South Texas. Interventions included reminder calls, multilingual education, districtwide communication, and a partnership with a nonprofit clinic that provides free or reduced-cost vaccines through on-site and community clinics. Pre- and post-intervention …

Ambient Listening: Using Artificial Intelligence To Transcribe Provider Office Visits, Odia Russette

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Electronic health record (EHR) documentation burdens contribute to increased “pajama time” or after–hours charting, reduced job satisfaction, and provider burnout. Provider burnout leads to provider and critical access point losses. Ambient–listening artificial intelligence (AI) technologies have emerged as a possible tool to reduce charting burdens; however, evidence from outpatient wellness settings remains limited.

Local Problem: At an urban adult wellness clinic in Texas with limited resources for completing tasks, in-clinic and after-hours “pajama time” charting burdens contributed to provider fatigue, job dissatisfaction, and burnout.

Methods: A quality improvement (QI) project using the Plan-Do-Study-Act (PDSA) framework implemented an AI ambient …