Digital Commons Network^™

Enhancing Nursing Documentation Accuracy For Female External Urinary Collection Devices Through Structured Documentation Huddles, Tiffany Ealy

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Accurate documentation of female external urinary collection devices (EUCDs), such as the PureWick, is crucial for maintaining continuity of care and ensuring efficient resource utilization. However, inconsistent nursing documentation practices have led to gaps in regulatory compliance and communication among healthcare teams. Baseline data revealed frequent omissions and inaccuracies in female EUCD charting, indicating a significant practice gap that requires targeted improvement.

Aim of the Project: The purpose of the evidence-based practice (EBP) project was to improve nursing documentation accuracy for female EUCDs by implementing structured documentation huddles, thereby enhancing organizational compliance.

Review of the Evidence: A …

Eat, Sleep, Console Care For Infants With Neonatal Abstinence Syndrome: A Multisite Evaluation, Amanda Fout

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Opioid use in pregnancy continues to rise, leading to increasing cases of neonatal abstinence syndrome (NAS). Traditional management with the Finnegan Neonatal Abstinence Scoring System (FNASS) often results in pharmacologic treatment, prolonged hospitalizations, and higher costs. Inconsistent FNASS scoring at the hospital system contributed to unnecessary NICU admissions and variable outcomes. Eat, Sleep, Console (ESC) was introduced as an alternative approach, but its effectiveness had not been formally evaluated.

Aim of the Project: The aim of the quality improvement initiative was to evaluate the effectiveness of the ESC model in improving outcomes for infants with NAS across three hospitals …

Implementing A Sepsis Questionnaire To Reduce Readmissions…A Health Plan’S Experience, Vernita L. Kelley

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Sepsis is a life-threatening condition with high readmission risk, threatening patient recovery and survival. In the managed care organization (MCO) where this DNP project was implemented, sepsis ranks among the top five readmission diagnoses. The organization's 30-day readmission rate of 15.5% is substantially higher than the benchmark of 9.29%, highlighting a clinical quality issue, a strain on patient outcomes, and a strain on healthcare resources.

Aim of the Project: This quality improvement (QI) project aimed to reduce sepsis readmissions by embedding a sepsis questionnaire into case management workflows to identify clinical risks and social determinants of health, improve transitions, …

Quality Improvement Initative To Reduce Falls Among Geriatric Patients In The Inpatient Mental Health Setting, Regina Johnson

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are widely recognized as a leading cause of injury and hospitalization among older adults, with geriatric psychiatric patients at particularly high risk due to polypharmacy, cognitive impairment, and mobility challenges. At the project site, baseline audits revealed inconsistent use of structured fall risk tools, limited nurse-driven medication review, and gaps in post-fall documentation. The absence of an embedded electronic health record feature for medication review highlighted a significant practice gap requiring intervention.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce fall risk in a geriatric psychiatric hospital through structured post-fall medication …

Fall Reduction Utilizing Fall Tailored Intervention For Patient Safety In Acute Care, Lauren Poindexter

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospitalized patient falls cause physical, psychological, and financial harm and persist despite prevention bundles. A Midwest Ohio acute medical unit experienced higher-than-benchmark fall rates (1.53–7.58 falls/1,000 patient days; unit rate 113% of the national median), with a rising trend in FY25. Reliance on the Schmid tool and existing interventions lacked structured patient/family engagement, as well as comprehensive medication assessment, leading to under-recognition of risk and limited nurse-driven prevention.

Aim of the Project: The aim of the project was to reduce inpatient fall rates and fall-related injuries on a medical unit by implementing the Agency for Healthcare Research and Quality …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Fall Prevention In Home Care: The Introduction Of The Steadi Initiative As Evidence-Based Tool, Margarida Barbosa - Barreiro

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls continue to be one of the leading causes of injury and mortality among older adults and remain a significant driver of healthcare utilization and cost. Within the home health setting, inconsistent practices in fall risk assessment and intervention have contributed to care gaps and increased patient vulnerability. The absence of a standardized, evidence-based process created the need for a structured quality improvement initiative to strengthen patient safety.

Aim of the Project: The purpose of this quality improvement project was to integrate the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit into home health visits to enhance the …

Advancing University Student Health And Wellbeing Through Peer-Led Health Promotion: A Quality Improvement Project​ ​, Rojeda Merani, Elizabeth Page, Elizabeth Roth

DNP Projects

Background: Peer-led health promotion is widely recognized as an effective strategy for increasing engagement, trust, and health literacy among university students. However, few frameworks guide development and implementation of these programs.

Objective: To evaluate the feasibility, implementation process, and perceived effectiveness of a peer-led health promotion model supported by Doctor of Nursing Practice (DNP) mentorship at a mid-sized private university.

Participants: Thirteen undergraduate students from a diverse set of academic programs were recruited as Peer Health Ambassadors (PHAs) and paired with DNP student mentors.

Methods: Guided by the Implementation Research Logic Model, the project used a four-phase QI process: targeted …

The Efficacy Of Emdr Therapy Compared To Tf-Cbt In Adopted Children To Manage Post-Traumatic Stress: An Integrative Review, Grace Ann Steiner

Senior Honors Theses

This integrative review examines the efficacy of eye movement desensitization and reprocessing (EMDR) therapy compared to trauma-focused cognitive behavioral therapy (TF-CBT) in managing post-traumatic stress disorder (PTSD) in adopted children. Children adopted from foster care tend to experience more adverse childhood experiences (ACEs) and maladjustment issues when compared to the general population, which necessitates effective therapeutic interventions to reduce PTSD symptoms and emotional dysregulation. Through analysis and comparison of the data, it was determined that both EMDR and TF-CBT effectively alleviated trauma-related symptoms, although one technique is not necessarily always more effective or efficient than the other. Along with reviewing …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

Artificial Intelligence And Medical Education (2013-2024): A Scopus-Based Bibliometric Analysis, Festus Mulakoli, Edward Misava

School of Nursing & Midwifery, East Africa

Background: Artificial Intelligence (AI) is transforming medical education by enabling personalised learning, adaptive feedback, simulation-based training, and automated assessments. While AI offers significant benefits, including curriculum optimisation and virtual tutoring, concerns around data privacy, access, and ethical implementation persist. Although bibliometric studies have explored AI in healthcare, comprehensive analyses of global collaboration and publication trends in AI-focused medical education remain limited. Aim: This study aims to analyse global research trends, key contributors, and thematic developments in the application of AI within medical education. Methods: A bibliometric analysis was conducted using the Scopus database. The search strategy included terms …

Program Evaluation Of Tms Treatment For Patients With Comorbid Major Depressive Disorder And Ptsd, Alec Wilson

Doctor of Nursing Practice

Nearly six million in the U.S. experience symptoms associated with the diagnoses of comorbid Major Depressive Disorder (MDD) and Post Traumatic Stress Disorder (PTSD). Many with these diagnoses fail to respond to first line treatments that include medication and psychotherapy. Transcranial magnetic stimulation (TMS) therapy is a non-invasive treatment option for individuals who fail to respond to first line treatments.

Methods: This program evaluation completed a retrospective chart review of adult patients with comorbid MDD and PTSD, who received TMS treatments at a private practice clinic between the time frame of September 2024 and October of 2025.

Results: All …

An Evidence-Based Practice Review: Outpatient Opioid, Narcan, And Non-Opioid Treatments For Pain Management, Kayla Culp

Doctor of Nursing Practice

Background: There were nearly 645,000 deaths from 1991-2021 related to opioid overdose. Despite the U.S. representing only four percent of the global population, Americans consume 80% of the world’s opioids. Ten million Americans misuse opioid prescriptions, and this contributes to the thousands of annual deaths. Preventable mortality related to the opioid epidemic persists despite advancements in primary, secondary, and tertiary prevention efforts.

Purpose: The purpose of this evidence-based practice (EBP) project was to compare components of CDC’s (Center for Disease Control and Prevention) Clinical Practice Guideline for Prescribing Opioids for Pain to current prescribing practices amid an ongoing …

A Program Evaluation Of An Integrated Mental Health Model In A Rural Primary Care Clinic, Shelley Rickett

Doctor of Nursing Practice

Background: Mental health issues are not unique to Eastern Montana, in February 2021 there were 44,000 adults in Montana diagnosed with a serious mental illness (NAMI,2021). Access to mental health services in Eastern Montana is challenging due to the number of small rural towns that have a significant distance between them. There is an insufficient number of mental health providers and counselors to cover this large geographical area, significantly impacting access to mental health services. In an attempt to impact mental health access, primary care clinics are integrating these services into an integrated mental health model.

Purpose: The …

Myplate For Healthy Diet And Physical Activity: A Pilot Project, Christin Sullivan

Doctor of Nursing Practice

Background: Over 100 million American adults are obese. This has increased from 38.5% in 2013-2016 to 41.8% in 2017-2020 and is predicted to keep rising. Significant health risks are linked to obesity, prompting weight loss movements at the local, national and global level. Recently, Semaglutide has been favored in weight loss programs but must be augmented by education on healthy diet and physical activity for weight reduction and maintenance.

Purpose: The purpose of this scholarly project was to pilot the MyPlate method on healthy diet and physical activity and determine its effects on patient knowledge of healthy diet and physical …

Supporting Discharge Preparation For Children With Medical Complexity: A Scoping Review, Emily Moore, Mia Waldron, Darlene Acorda, Cara Gallegos, Barbie Giambra, Stacee M. Lerret, Christine R. Platt, Danielle A. Sarik, Zara Sajwani-Merchant, Nesibe Sumeyye Kutahyalioglu, Pamela Gampetro, Susan Groshong, Marianne Weiss, Teri L. Hernandez, Sandra Staveski

College of Nursing Faculty Research and Publications

Background

The transition from hospital to home is a critical period for children with medical complexity (CMC) and their caregivers, often associated with increased risks and stress. Both registered nurses and advanced practice nurses play a pivotal role in facilitating this transition through discharge preparation, including planning, coordination, and teaching. However, best practices for optimizing discharge processes for CMC remain unclear. The need for a comprehensive understanding of hospital discharge during this crucial time is apparent as adverse events following discharge are common and are often attributed to insufficient preparation and communication. This scoping review aims to identify key nursing …

Artificial Intelligence And Academic Integrity In Nursing Education: A Mixed Methods Study On Usage, Perceptions, And Institutional Implications, Maggie Zgambo, Martina Costello, Melanie Buhlmann, Justine Maldon, Edah Anyango, Esther Adama

Research outputs 2022 to 2026

Background: The rise of artificial intelligence (AI) use in higher education has generated substantial debate among academics and students, given the potential for students to engage in academic misconduct through the misuse of AI. Academics argue that AI poses a serious threat to the foundational development of nurses through the questionable integrity of AI-generated academic work and by undermining the development of critical thinking skills essential for professional practice. However, there is limited research on nursing students' integration of AI technologies in their studies.

Method: This study utilised a convergent parallel mixed methods approach to develop a multiphase approach with …

Co-Designing A Resilience-Based Mentoring Program For Novice Midwives: A Participatory Action Research Approach, Dianne Bloxsome, Tracy Martin, Kaoru Nosaka, Sara Bayes

Research outputs 2022 to 2026

Aim: To co-design a resilience-based mentoring program for novice midwives in Western Australia, informed by the experiences of past midwifery graduates and the perspectives of midwives in senior roles. Background: Effective workforce planning and retention strategies are essential in preventing the continued loss of midwives and in attracting newly qualified midwives to healthcare organisations. Transitioning from student to registered midwife is a known period of vulnerability that requires structured, evidence-informed support. Design: A Participatory Action Research (PAR) approach was adopted to collaboratively develop a mentoring program tailored to the transition needs of newly qualified midwives. Methods: Fourteen participants contributed to …

I’M Here Whether I Like It Or Not: A Focused Ethnographic Description Of Transition Into Residential Aged Care, Stacey Scott, Annette Raynor, Julie Dare, Jennifer Grieve, Leesa Costello

Research outputs 2022 to 2026

Transition into residential aged care (RAC) is a challenging process, often characterised by vulnerability, fear, and isolation. This study aimed to provide a contextualised description of transition within a care-facility in Australia to deepen our understanding of this major life event. A focused ethnography was conducted, which included formal interviews with residents during their first 6 months of living in RAC. The findings provide an account of the participants’ views on acceptance, highlight the challenges of loss, and showcase the coping practices new residents used. This paper provides a type of report card for the sector, which reveals that there …

A Five-Country Comparison Of Midwifery Students' Confidence In Facilitating Normal Labor And Birth, Juliet Wood, Jalana Lazar, Barbara Baranowska, Clare Davison, Debora Dole, Cindy L. Farley, Jane Fry, Maria Healy, Felicity Agwu Kalu, Urszula Tataj-Puzyna, Emma Ritchie, Maria Wegrzynowska

Research outputs 2022 to 2026

Introduction: Midwifery students need confidence in recognizing and supporting normal birth, the backbone of the midwifery professional role. Developing this confidence in the face of decreasing rates of physiological birth worldwide is a critical challenge. Midwife researchers from Australia, England, Northern Ireland, Poland, and the USA investigated midwifery student confidence for supporting normal birth and explored enhancing and detracting factors. Methods: A cross-sectional survey design was undertaken with 570 midwifery students at 8 academic midwifery programs across 5 countries The Student Confidence for Supporting Normal Birth Questionnaire with free text and Likert-type questions on a 1 (least influential) to 4 …

Woman-Centred Ethical Grid For Midwifery Education: A Content Analysis, Kate Buchanan, Darcie Bygraves, Emma Ritchie, Krystyl Toneycliffe, Sara Bayes, David Seedhouse

Research outputs 2022 to 2026

Background: Midwives across the world are required to practice in accordance with an internationally agreed set of ethical principles. Midwifery education for many students includes ethics theory content, but this does not necessarily provide them with the skills toward ethical competence in practice. Aim: To understand students' perception of ethical issues and to use these findings as foundational information with which to create an ethical deliberation tool for practice. Methods: Qualitative Content Analysis was used for this study. Purposive sampling provided twenty-one ethics-focused reflective assignments from one Western Australian university. Ethical considerations: Institutional review board approval was obtained. Findings: Three …

Understanding Interprofessional Co-Debriefing Practices Within Large Scale Ward-Based Simulation, Melanie Barlow, Robyn Dickie, Alycia Jacob, Shari Maver, Nick Flynn, Alison Blunt, Susan Darzins, Hugh Davies, Michelle Smith-Tamaray, Elisabeth Jacob

Research outputs 2022 to 2026

Background: Despite growing use of interprofessional simulation in healthcare education, there is a lack of published frameworks to guide structured, co-facilitated debriefing between professions. This study explored how nursing and allied health facilitators engage in interprofessional co-debriefing within a large-scale, ward-based simulation program involving over 2000 health students. Methods: Twelve interprofessional co-debriefings were observed and assessed using the debriefing assessment for simulation in healthcare (DASH) tool, with both rater (observer) and instructor (debriefer) versions. Mean debriefing assessment for simulation in healthcare (DASH) scores were compared across five core elements. Qualitative data from instructor short-answer responses and observer field notes were …

Global Perspectives Of Midwifery Ethics: Crucial Features For Practice Via An International Delphi Study, Kate Buchanan, Sara Bayes, Elizabeth Newnham, Mavis Kirkham, Marianne Nieuwenhuijze

Research outputs 2022 to 2026

Background: Practising ethically as a midwife is essential for providing high quality care during pregnancy, childbirth, and the postpartum period. Whilst midwives may have theoretical knowledge of ethics, applying ethical care in practice may be challenging. There is a gap in the literature that describes how midwives themselves conceptualise, interpret, and apply ethics in their practice. Aim: To describe midwives’ perceptions, and experiences of ethics in midwifery practice, and to determine the crucial features of midwifery ethics. Methods: Fifty participants from 21 countries participated in the study. A two-round Delphi approach was employed. Round Two required participants to enter the …

Noise-Optimized Cone-Beam Computed Tomographic Imaging Of Different Post Materials With Multiple Settings: A Comparative Analysis, Solaleh Shahmirzadi, Dilek Helvacioglu-Yigit, Umut Seki, Maharaj Singh, Sarang Saadat, Husniye Demirturk Kocasarac

College of Nursing Faculty Research and Publications

Purpose The aim of this study was to evaluate the effect of 4 different post materials on the contrast-to-noise ratio (CNR) in various tooth regions using multiple cone-beam computed tomography (CBCT) imaging settings and metal artifact reduction (MAR) algorithms. Materials and Methods Forty single-rooted teeth with 4 different post materials were mounted in a skull and scanned using the Planmeca ProMax 3D Max under different conditions: 90 and 96 kVp; no, medium, and high MAR settings; and voxel sizes of 100 and 200 μm. Image analysis was performed with ImageJ software to calculate CNR. The dose-area product (DAP) was recorded, …

Quality Improvement Project Improving Faculty Support For First-Generation Rural Nursing Students, Charlotte Dowdy

Doctor of Nursing Practice Projects

The barriers to academic success among first-generation rural nursing students are substantial, including a lack of knowledge of academic resources, ineffective study strategies, and difficulty navigating the higher education system. These challenges are documented in the literature as resulting in higher attrition rates and lower graduation rates. This quality improvement project was intended to implement and analyze a faculty training module designed to increase faculty awareness and confidence in supporting first-generation rural nursing students at the project site. The project adopted a pre-post intervention design based on High-Reliability Organization principles and Lewin’s Change Model, to determine the effectiveness of targeted …

Staff Education And Implementation Of Phq-9 And Gad-7 In An Adult Psychiatric Private Practice, Exta Oppong Tweneboa

Walden Dissertations and Doctoral Studies

The PHQ-9 and the GAD-7 are short screening instruments used for the detection of depression and anxiety symptoms in various settings, including general and mental health care settings (Pranckeviciene, et al., 2022). The purpose of this Doctor of Nursing Practice (DNP) project was to educate staff on the implementation of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) into an adult psychiatric private practice to standardize screening, improve diagnostic accuracy, and support measurement-based care for depression and anxiety. A structured staff education program was conducted with five nurse practitioners, one psychiatrist, two therapists, and two front-end administrative staff. …

Quality Improvement Project Implementing Teamstepps 3.0: Impact On Perception Of Teamwork, Angela Allen

Doctor of Nursing Practice Projects

The clinical practice site is a rural health clinic that has experienced 28% staffing turnover in the last year, and opportunities for improvement in communication and teamwork were identified. The principal investigator (PI) used the Iowa Model Revised (IMR) as a theoretical framework and Lippitt’s change theory to promote change for the identified priority issue. TeamSTEPPS is an evidence-based program designed to improve communication and teamwork in healthcare teams with the goal of improving patient outcomes and safety. The quality improvement project utilized a quasi-experimental design with pre- and post-intervention surveys to answer the question: among staff at a rural …

Quality Improvement Project Improve Staff Knowledge On Spravato For Treatment Resistant Depression, Cynthia Barraza Guerra

Doctor of Nursing Practice Projects

Treatment-resistant depression (TRD), defined as major depressive disorder unresponsive to at least two adequate antidepressant trials, is linked to higher morbidity, diminished quality of life, and increased healthcare utilization. Spravato (intranasal esketamine), approved by the U.S. Food and Drug Administration, provides a novel mechanism of action through N-methyl-D-aspartate (NMDA) receptor modulation but requires strict safety oversight due to risks including dissociation and hypertension. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated whether a targeted educational intervention improved staff knowledge and confidence in Spravato safety protocols. Guided by Lewin’s Change Theory, Bandura’s Social Learning Theory, and implemented with …

Quality Improvement Project High-Quality Simulation Training For High-Quality Nurse Educators, Cherrelle Hawkins

Doctor of Nursing Practice Projects

The Associate of Applied Science in Nursing (AASN) faculty use simulation as a teaching modality to assist nursing students in preparing for their clinical experiences by transitioning knowledge into practice. To successfully facilitate simulations, faculty must possess knowledge and competence in facilitating simulation sessions. Faculty at the practice site lacked these characteristics due to the nonexistence of a simulation training program. This quasi-experimental quality improvement project aimed to implement formal simulation training for faculty to influence self-perceived knowledge and competence in facilitation constructed by the Adult Learning Theory and the Awareness-Desire-Knowledge-Ability-Reinforcement (ADKAR) Change Model. The PI evaluated knowledge and competence …

Quality Improvement Project Impacting Provider Self-Efficacy And Use Of Cbt For Depression Treatment, Tony Orafunam

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement project was conducted at a mid-sized outpatient psychiatric clinic in Hempstead, New York, focusing on strengthening providers’ self-efficacy in delivering Cognitive Behavioral Therapy (CBT) to young adults (aged 19–35) diagnosed with Major Depressive Disorder (MDD). Rather than targeting MDD directly, the initiative aimed to impact provider self-efficacy and skill in CBT to improve access to evidence-based treatment and reduce the need for external referrals. Employing Bandura’s Social Cognitive Theory and the ADKAR change model, the project used a quasi- experimental, one-group pre-test/post-test design. Six advanced practice providers participated in a structured, interactive …