Digital Commons Network^™

Quality Improvement Project: Provider Education On An Evidence-Based Clinical Pathway For Diagnosing Adult Attention-Deficit Hyperactivity Disorder, Oluwadayo B. Adeyemo

Doctor of Nursing Practice Projects

Accurate diagnosis of adult Attention-Deficit Hyperactivity Disorder (ADHD) remains challenging in outpatient behavioral health settings, as variations in clinician training, diagnostic tools, and assessment methods can hinder accuracy and delay treatment. At the project site, providers reported low confidence and inconsistent use of standardized tools when evaluating adult ADHD, underscoring a critical need for structured education to improve diagnostic consistency and provider confidence. This quality-improvement (QI) project assessed the impact of an educational intervention on provider knowledge, confidence, and utilization of validated screening tools for adult ADHD. Guided by Donabedian’s Model of Quality Improvement and Lewin’s Change Theory, the project …

Quality Improvement Project: The Impact Of Genetic Testing Education For Mental Health Providers In An Outpatient Clinic, Ifeoma Uzoh-Anigbogu

Doctor of Nursing Practice Projects

Despite growing evidence supporting the use of genetic screening in psychiatric medication management, many mental health providers lack the confidence and knowledge to utilize this tool effectively. This quality improvement (QI) project aimed to enhance provider self-efficacy and increase the utilization of genetic screening through a structured education and training program in an outpatient mental health clinic. The purpose of the project was to determine whether provider education on pharmacogenetic testing improves confidence and screening frequency compared to those who do not receive the intervention. The Donabedian Model guided evaluation of structure, process, and outcome measures, while Rogers’ Diffusion of …

Quality Improvement Project, Communicating With The Dying Patient: A Simulation Experience For Nursing Students, Jason Weger

Doctor of Nursing Practice Projects

Effective communication with patients near the end of life is a crucial yet often underdeveloped skill among nursing students. Previous research highlights a persistent gap in training for end-of-life communication in nursing schools. This quality improvement project implemented a simulation-based educational intervention to improve end-of-life communication skills among first-semester nursing students at a community college in Oklahoma. A needs assessment identified significant gaps in students' readiness for emotionally charged patient interactions. Guided by Prosci’s Change Model and Jeffries Simulation Theory, the project used a faculty-led simulation experience to teach evidence-based communication strategies, including appropriate word choice, therapeutic presence, and active …

Quality Improvement Project: Reducing Hospitalizations In The Long-Term Care Setting, Nenna Nzeocha

Doctor of Nursing Practice Projects

Hospitalizations in the long-term care setting can lead to higher costs incurred by skilled nursing home residents and a poorer quality of life. This quality improvement (QI) project evaluated whether an educational intervention on the Reducing Avoidable Facility Transfers (RAFT) model impacted hospitalization rates in the skilled nursing facility (SNF), while also assessing the confidence level of facility staff on the intervention. The project utilized Lewin’s change theory and the Donabedian model framework and was aimed at developing interventions that impact hospitalizations in the SNF using the RAFT model. A quasi-experimental design was used and consisted of a pre-and-post implementation …

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 …

Quality Improvement Project: Improving Nurse Competency In Caring For Patients With Dementia With Behavioral Disturbances In Long-Term Care, Lashunta Jackson

Doctor of Nursing Practice Projects

Dementia-related behavioral and psychological symptoms (BPSD) present major challenges for nurses in long-term care settings, often leading to inconsistent care, staff stress, and safety risks. Evidence-based, person-centered interventions are proven to improve outcomes but are frequently underutilized due to limited staff training. The purpose of this Doctor of Nursing Practice (DNP) project was to improve nursing staff competency in managing residents with dementia and behavioral disturbances through structured, evidence-based education. The problem identified was a lack of dementia-specific knowledge and confidence among nurses, which contributed to suboptimal care and increased behavioral incidents. A quasi-experimental pre-/post-intervention design guided by Knowles’ Adult …

Improving Self-Efficacy Among Clinical Instructors: The Impact Of Communication Education On Handling Lateral Violence, Emma Guidry

Doctor of Nursing Practice Projects

The quality improvement (QI) project aims to determine if clinical instructors perceive changes in self-efficacy in communication skills specific to lateral violence (LV) situations secondary to an educational intervention. Currently, clinical nurse instructors lack education specifically addressing communication strategies to utilize when LV occurs in the clinical setting. Banduras Social Cognitive Theory, Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) were employed as frameworks in the development of this project. Methods used in this quasi-experimental design project include administration of the Self Efficacy to Address Disruptive Behaviors Scale (SADBS) survey to project participants, nursing clinical instructors. The evidence-based practice (EBP) intervention …

Resiliency For Nurse Educators: Incorporating Resiliency Training For Nursing Faculty, Rachael Holder

Doctor of Nursing Practice Projects

Nursing faculty frequently experience high levels of stress, workload demands, and burnout, which can negatively affect teaching effectiveness and retention. Literature supports resilience as a protective factor that enhances well-being and professional sustainability. The purpose of this quality improvement project was to impact resilience levels among full-time undergraduate nursing faculty through a self-paced online resiliency training program. Guided by Pender’s Health Promotion Model and Lewin’s Change Theory, this pre- and post-intervention design used the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to assess changes in resilience. Eleven faculty members completed the pre-survey, and two completed the post-survey. The post-survey mean CD-RISC-10 scores …

Quality Improvement Project Implementation Of A Peer Mentoring Program In An Associate-Degree Nursing Program, Heather Baker

Doctor of Nursing Practice Projects

Peer mentoring is recognized as an evidence-based strategy that offers support to students and enhances retention. This project aimed to implement a peer mentoring program based on the Nursing Universal Retention and Success (NURS) model. The Plan-Do-Study-Act (PDSA) framework and Havelock’s Theory of Planned Change guided the implementation process. The goal was to assess the program's impact on first-semester nursing student retention rates and students’ perceptions of success. First-semester nursing students in a traditional associate-degree nursing program volunteered to participate in the peer mentoring program for one semester. At the end of the semester, an anonymous post-survey was distributed to …

Quality Improvement Project: Improving Emergency Medication Administration Safety In An Inpatient Psychiatric Unit, Sandra Anusiem

Doctor of Nursing Practice Projects

Psychiatric emergencies contribute to medication safety issues due to increased stress, inconsistent practices, and communication breakdowns. The problem was high rates of medication errors in psychiatric emergencies due to the lack of a structured, standardized medication management protocol. This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce medication errors in administering emergency medications in an inpatient psychiatric unit by using the Medication Administration Cross-Check (MACC) checklist. The project was completed using a quasi-experimental research design guided by the Donabedian Model of Healthcare Quality and Lewin’s Change Model. Pretest and posttest knowledge, confidence, attitude, and perceptions were obtained …

Reducing Falls In The Acute Care Setting: A Quality Improvement Project, Elorm M. Adzokpa

Doctor of Nursing Practice Final Project Abstract

Falls remain one of the most common adverse events in acute care settings and are associated with increased morbidity, extended hospital stays, and higher healthcare costs. Orthopedic and trauma patients are particularly vulnerable due to mobility limitations, postoperative recovery, and complex medical conditions. The purpose of this quality improvement project was to reduce inpatient falls on an adult orthopedic and trauma unit by implementing a visual aid to reinforce the 5P fall-prevention framework. A pre–post quality improvement design was used during an eight-week implementation period. The intervention included a standardized fall prevention bundle that reinforced existing Fall TIPS board use …

Quality Improvement Project: Educating Nursing Faculty On Medication Administration Labs To Improve Student Competency, Chelsea Pacheco

Doctor of Nursing Practice Projects

Medication administration errors are a leading cause of preventable harm in healthcare. Faculty play a critical role in ensuring nursing students develop the knowledge and confidence to give medications safely. A needs assessment at the project site revealed that only course coordinators were teaching medication administration and dosage calculation, leaving other faculty uncertain about how to teach these skills. This quality improvement project aimed to strengthen faculty confidence and create consistency in first-year instruction through a recorded educational video. Constructivist Learning Theory provided the foundation for active, experience-based learning. Lewin’s Change Theory guided the structured implementation process to support adoption …

Quality Improvement Project: Enhancing Diabetes Management Through Continuous Glucose Monitoring Device Education Among Providers Of Underserved Groups, Shaibu Rashid

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance diabetes management among underserved populations by increasing provider confidence and utilization of continuous glucose monitoring (CGM) devices in a Federally Qualified Health Center (FQHC). Despite CGM being recognized as a standard of care for patients requiring intensive insulin therapy, its adoption in FQHCs remains limited due to provider knowledge gaps, financial barriers, and workflow challenges. Based on Kurt Lewin’s change theory, the project employed a quasi-experimental one-group pretest–posttest design to evaluate the impact of an evidence-based educational intervention among six family practice providers. The intervention included interactive sessions on CGM device use, data …

Establishing Nursing Excellence: A Quality Improvement Approach To Nursing Administration Evaluation Using Frontline Feedback, Meredith Sykora

Doctor of Nursing Practice Projects

In the increasingly complex environment of nursing education, leadership quality and responsiveness significantly influence workplace culture, faculty satisfaction, professional development, and student outcomes. Despite these realities, many academic nursing programs, including the Division of Nursing at a community college in Arkansas, lack formal structures for bidirectional leadership evaluation. This gap limits frontline faculty’s ability to provide formative feedback to program leaders, weakening shared governance and transparency. The purpose of this quality improvement project was to evaluate leadership effectiveness following the implementation of a structured bidirectional feedback process between nursing faculty and program leaders. Guided by Kouzes and Posner’s Leadership Practices …

Investigating The Mechanisms By Which Gut Microbiome Dysbiosis Contributes To The Autoimmune Response In Multiple Sclerosis, Abigail Houtrouw

Honors Theses

This literature review explores the multifaceted relationship between gut microbiome (GM) dysbiosis and multiple sclerosis (MS), highlighting key themes that advance understanding of disease pathogenesis and therapeutic potential for treatments targeting the gut. The review underscores the immune system dysregulation in MS, emphasizing the roles of T cells, B cells, and microglia in neuroinflammation and demyelination. Historically, MS pathogenesis was thought to be driven mainly by T-cell dysregulation, but current research highlights the additional roles of B-cells and microglia, the resident immune cells of the central nervous system (CNS). Additionally, this literature review identifies GM alterations and dysbiosis as critical …

Reducing Opioid Overdose Harm Through Narcan Access And Education, Shane Alexander Role Alihan, Jared Timothy Chua, Siwapond (Taylor) Yuen, Matthew Reynon

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

Background: The overuse of opioids has led to an epidemic that affects the health of young adults in Sacramento, CA. Social and economic factors have influenced the use of opioids which has led those individuals to acquire an addiction and dependency to such drugs. This age group is typically engaged in college and career-minded endeavors. Thus, the impact on this age group is substantial, requiring impactful interventions.

Aim: The purpose of this intervention is to provide a foundation for educating those affected by opioid overdose. This strategic goal is to equip students at the University of the Pacific’s Entry-Level …

Enhancing Alzheimer's Care: Impact Of Staff Education On Behavioral Outcomes, Laura Caton Rn

Nurse Residency

Would additional staff training and education in Alzheimer’s patient interactions compared to minimal/or no staff training and education in Alzheimer’s patient interactions lead to reduced behavioral events in bedside nursing?

Positioning The Surgical Patient, Jennifer Condon Rn, Bsn

Nurse Residency

For patients undergoing surgery does implementation of AORN standard for safe positioning practice compared toa non-standardized approach improve surgical outcomes?

Editorial Board

Nursing & Health Sciences Research Journal

No abstract provided.

Implementation Of An Institution-Specific Checklist To Improve Compliance With Discharge Round Completion In A Neonatal Intensive Care Unit, Lee A. Lawson

Student Scholarly Projects

Practice Problem: Effective discharge planning for premature infants in the NICU requires collaboration and coordination among multidisciplinary interprofessional (IP) teams. Ineffective communication during care transitions is a well-documented contributor to adverse patient outcomes, including prolonged hospitalization.

PICOT: For multidisciplinary, interprofessional teams in the NICU (P), how does the introduction of an institution-specific discharge checklist (I), compared to the current unit discharge process (C), affect multidisciplinary, interprofessional team compliance with completing weekly discharge rounds (O) within 6 weeks (T)?

Evidence: The reviewed literature supported the use of a discharge checklist tool to facilitate effective team communication and care coordination with parents …

Anesthesia Informed Consent: An Objective Structured Clincial Examination, Joshua Powell

Doctoral Projects

Informed consent is a fundamental component of anesthesia practice and is recognized as professional Standard IV by the American Association of Nurse Anesthesiology (AANA). Despite its importance, anesthesia providers often face challenges in effectively obtaining consent from patients. Within The University of Southern Mississippi (USM) Nurse Anesthesia Program (NAP), a need was identified to strengthen student competency in conducting anesthesia informed-consent discussions. This project developed and implemented an Objective Structured Clinical Examination (OSCE) as a standardized, evidence-based approach to teach and assess informed-consent skills in alignment with the American Association of Nurse Anesthesiology (AANA, 2019) standards. The intervention was designed …

Implementing The Steadi Fall Risk Screening Initiative Within A Primary Care Setting To Improve Patient Safety, Haleigh Marie Brown

Doctoral Projects

Falls among older adults are a significant public health issue and the leading cause of injury-related illness and death in people aged 65 and older. While evidence-based guidelines exist and awareness of fall risks has increased, many primary care settings do not use standardized fall risk screening protocols. This gap results in missed opportunities for early identification and prevention. To address this need, the Centers for Disease Control and Prevention (CDC, 2019) created the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Toolkit, which offers healthcare providers a structured approach to assess, manage, and reduce fall risk.

This doctoral project aims …

Point-Of-Care Gastric Ultrasound For Preoperative Assessment Of Gastric Contents: An Objective Structured Clinical Examination, Joshua Mann, Michael Sykes

Doctoral Projects

Pulmonary aspiration remains a leading cause of anesthesia-related mortality. The current nil per os (NPO) guidelines are proving unreliable in the presence of delayed gastric emptying due to comorbidities and the increasing use of glucagon-like peptide-1 (GLP-1) agonists. Gastric point-of-care ultrasound (POCUS) use provides a non-invasive, evidence-based, and cost-effective approach to assess gastric content and volume directly. However, limited formal training exists for advanced practice registered nurses (APRNs), and this lack of training contributes to the lack of its utilization. This doctoral project evaluated the effectiveness of an educational intervention that incorporated a didactic lecture as well as a hands-on …

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 …

The Impact Of Awake Prone Positioning In The Patient With Covid-19, Ellie Butsch, Margo Halm, Ann Alway, Eliza Burkholder, Julia Koos

Nursing & Health Sciences Research Journal

Background: Prone positioning has been shown to improve clinical outcomes for sedated, mechanically ventilated individuals with moderate to severe respiratory illnesses. Some studies also show potential benefit to awake individuals with COVID-19.

Objectives: The primary aim of this study was to investigate if hospitalized non-critically ill individuals diagnosed with SARS-CoV-2 who engage in frequent proning are more likely to have improved outcomes compared to non-proning individuals.

Methods: A retrospective cohort design was used to assess outcomes associated with awake prone positioning. A convenience sample was used to select two cohorts of individuals admitted with COVID-19 from April 2020-March 2021. Cohort …

The Role Of Forgiveness In Health And Healthcare: Perspectives From Graduate Nursing Students And Faculty At A Private Faith-Based University In The United State[S], Rachel A. Joseph, Shanna W. Akers, Jichan J. Kim

Faculty Publications and Presentations

No abstract provided.

Cv: Daisy Sherry (Nursing), Daisy Sherry

Nursing Department Faculty Curricula Vitae

No abstract provided.

Lived Experiences And Educational Needs Of Women With A History Of Preeclampsia: A Qualitative Phenomenological Study In Indonesia, Fitriana Fitriana, Ani Kristianingsih, Nopi Anggistaputri

Journal of Asian Midwives (JAM)

Background: preeclampsia (PE).\ is one of the leading causes of maternal morbidity and mortality worldwide Many pregnant women fail to recognize early warning signs of the condition despite attending antenatal care, for reasons such as limited understanding of PE symptoms and/ or inadequate communication of health information by healthcare providers. Women with a previous history of PE are particularly vulnerable and require targeted educational support during subsequent pregnancies.
Methods: Eight pregnant women with a documented history of PE in their second or third trimester participated in in-depth semi-structured interviews using an interpretative phenomenological technique.  To ensure credibility and reliability, the …

Too Young, Too Risky: Maternal And Neonatal Outcomes Of Teenage Pregnancy In Pakistan, A Scoping Review, Sumia Andleeb Abbasi, Noor E Marfa Shivji, Warisha Qamar, Tayyaba Riaz Abbasi, Abdullah Riaz Abbasi, Raja Adan Asif

Journal of Asian Midwives (JAM)

Introduction: Teenage pregnancy is a global concern that affects both the developed and developing regions. Adolescent pregnancy is associated with serious maternal and child health outcomes. This paper aims to identify the prevalence and patterns of maternal child health outcome of adolescent’s pregnancies.
Methods: This review utilized the PRISMA-ScR guidelines. To identify the outcomes of the adolescent pregnancies, a wide-ranging search strategy was implemented. Data were extracted from 15 eligible studies with a total population of 5692participants from Pakistan. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Only quantitative methods were included.
Results: The review of 15 …

Predictors Of Complications Among Adult Patients Diagnosed With Type 2 Diabetis Mellitus At Thika Level Five Hospital, Kenya, Bernard Wambua Mbithi

MSc in Advanced Practice Nursing

Introduction: Despite advances in the management of Type 2 diabetes mellitus (T2DM), anecdotal reports from Thika Level Five Hospital indicate that patients still present with diabetes mellitus-associated complications. Therefore, this research aimed to determine the predictors of complications among adult patients diagnosed with T2DM in the hospital.

Methodology: Analytical cross-sectional design was utilized in this research. To select the respondents, purposive sampling was used to recruit six nurse managers and their deputies (making a total of 12 nurses), while 294 patients in the clinic were recruited using systematic sampling. Purposive sampling was also used to recruit 15 patients …