Digital Commons Network^™

Detection And Evaluation Of Biofilm-Producing Clinical Bacterial Isolates By Tcp Method In Karbala-Iraq, Huda Ali Salman Almosawey

Al-Esraa University College Journal for Medical Sciences

Background: A biofilm is a complicated, three-dimensional microbial community that forms at an interface and interacts with its surroundings. To detect the ability of bacteria to form biofilms, the Tissue Culture Plate Method (TCP) is one of the most widely accurate methods and is frequently used with clinical isolates. Objective: This study aims to determine the ability of clinical bacterial isolates to form biofilms using the TCP method and to compare biofilm production between different types of bacteria; to study the relationship between biofilm formation and antibiotic resistance, which helps in understanding the reasons for the failure of some antibiotic …

Global Trends And Research Landscape Of Metformin And Artificial Intelligence: Bibliometric Analysis, Raya Doraid Mohammed, Alaa Qasim Hayder, Hamza A. Saadallah, Ali Q Saeed, Alice Louis Yousif, Safa M Salim, Noor Mahmood Sultan, Mohammed Ahb. Al-Krdoshi

Al-Esraa University College Journal for Medical Sciences

This bibliometric study examines global research trends and key thematic areas in Artificial Intelligence (AI) applications related to Metformin, especially in diabetes treatment. A total of 227 articles were retrieved from the Science Citation Index Expanded (Web of Science Core Collection) from 2020 to 2024. VOSviewer and CiteSpace were used to analyze publications by year, country, institution, journal, citation impact, and keyword co-occurrence. The United States, Canada, and South Korea contributed over 85% of the output, with leading institutions including the University of California, Los Angeles. Keyword mapping identified ``machine learning,'' ``Metformin,'' and ``Type 2 Diabetes'' as the most influential …

Clinical Interactions Of Celiac Disease And Relationship With Type 1 And Type 2 Diabetes Mellitus, Noor Thair Tahir, Raghda Shams Akram, Aseel Ibrahim Abbas, Sahar Abdul Wahab Alshaban, Fatma Abd Alhamza Obed

Al-Esraa University College Journal for Medical Sciences

Celiac disease is a typical autoimmune ailment that can be brought on by gluten, a protein present in wheat, barley, and rye. It is estimated that one person out of every 100 worldwide has celiac disease, with the majority going untreated. Although it can manifest asymptomatically, celiac disease is typified by a variety of gastrointestinal and extra-intestinal symptoms. The consistency of clinical, serological, and histopathological data is essential for the diagnosis of celiac disease. The diagnosis, nevertheless, is often missed and can be difficult. A higher risk of complications and a negative impact on quality of life are linked to …

Mpox Preparedness And Pandemic Memory: An Exploratory Study Among Young And Highly Educated Populations In Iraq, Israa M. Ali Alameen

Al-Esraa University College Journal for Medical Sciences

No abstract provided.

Determination The Prevalence Of Multidrug Antimicrobial Resistance Of Nosocomial Enterobacter Cloacae Isolates From Clinical Specimens In Baghdad Hospitals, Baidaa Mijbel Ali

Al-Esraa University College Journal for Medical Sciences

Background: Enterobacter cloacae have challenged global health through nosocomial infections, especially among immunocompromised patients. In the most overburdened healthcare systems, more study and strategy are anticipated. Aim of the study: To determine the prevalence of Enterobacter cloacae in hospital-acquired infections in Baghdad hospitals and to evaluate its antimicrobial resistance patterns across burn, wound, and urine samples, with a focus on multidrug resistance and antibiotic resistance trends. Methods: Three hundred and seventy-seven patient samples were collected and examined at a teaching laboratory in Baghdad between January 2024 and December 2024. These had 513 samples, 238 burn swabs, 139 wound swabs, and …

Epidemiology, Classification, Risk Factors, Pathophysiology And Management Of Diabetes Mellitus: A Review, Mohammed Raad Khalaf, Tariq Muhammed Ali, Entedhar K. Hussain, Alaa Al-Noori

Al-Esraa University College Journal for Medical Sciences

Diabetes mellitus is a common metabolic disorder, remains a global health challenge with escalating prevalence rates, necessitating a thorough understanding of its multifaceted aspects for effective management. This review synthesizes current knowledge on the epidemiology, classification, risk factors, pathophysiology, and management strategies of diabetes. The epidemiology highlights the rising global prevalence of DM and its regional variations, emphasizing the socio-economic and demographic factors contributing to this epidemic. The classification provides an in-depth analysis of the evolving classification systems, encompassing Type 1, Type 2, and gestational diabetes. Risk factors associated with the development of diabetes are explored, encompassing genetic predisposition, lifestyle …

Quality Improvement Project: Implementation Of The Patient Health Questionnaire-9 Modified For Teens, Hedy Gerber, Leah Buchko, Jennifer Van Winkle

All Faculty and Staff Scholarship

Background: Adolescent depression is a prevalent and significant public health concern, strongly linked to increased suicidality, poor health outcomes, impaired psychosocial functioning, and substantial societal costs. Although measurement‑based care using validated screening instruments is recommended by clinical practice guidelines, routine use of standardized depression screening tools remains limited in mental health settings.

Objective: The purpose of this quality improvement project was to assess the impact of implementing the Patient Health Questionnaire-9 modified for teens (PHQ-9M) in depression screening rates among adolescents aged 11-17 years at an outpatient mental health clinic in Southern Colorado.

Methods: A quantitative, quasi‑experimental pre- and post-intervention …

Staff Education To Enhance Knowledge Of Blood Culture Collection Technique To Reduce Blood Culture Contamination Rates, Whitney Ducharme

Walden Dissertations and Doctoral Studies

No abstract provided.

Hypertensive Disorders Of Pregnancy, Covid And Readmission Status, Margaret Luebke, Ross Bindler, Trisha Saul, Linda Trinh

Publications 2026-present

No abstract provided.

Enhancing Hiv Prevention: Implementation And Evaluation Of A Standardized Hiv Risk Assessment Screening In A Primary Care Setting, William Duckworth

Doctoral Dissertations

Background: HIV remains a persistent public health concern, with 1.3 million people affected worldwide. Although advances in treatment have improved long-term management, early prevention still relies on identifying individuals at elevated risk. In many primary care settings, routine HIV risk assessment is inconsistent or absent, resulting in missed opportunities to screen, educate and initiate prevention strategies such as pre-exposure prophylaxis (PrEP). This gap underscores the need for structured, evidence-based tools to improve early risk identification and strengthen HIV prevention efforts. Purpose: Implement and evaluate an evidence-based standardized screening process for HIV risk assessment to achieve early identification and enhance appropriate …

Nurses' Perspectives On Caring For Critically Ill Children During A Measles Outbreak: A Case Report, Nicole Roehrig

All Podium Presentations

No abstract provided.

Increasing Efficiency And Flow In Primary Care Clinics Using Triage Protocols Based On The Donabedian Model, Verneita Mun

Doctor of Nursing Practice Projects

Purpose

This project evaluated the effectiveness of triage protocols based on the Donabedian model in increasing efficiency and flow in primary care clinics. Patients experienced extended wait times in primary care clinics, resulting in aggravated outcomes and dissatisfaction with care delivery. Healthcare providers also experienced stress and burnout due to workload and operational inadequacies. These inefficiencies mandated a quality improvement approach that addressed patient satisfaction, workflow optimization, and resource management.

Methods

This project used structured triage protocol based on the Donabedian model, which addressed the dimensions of structure, process, and outcomes. The proposed solution was disseminated through a quality improvement …

Implementation Of Comprehensive Checklist For Opioid Use Disorder Treatment In Primary Care, Sophia R. Madden

Doctor of Nursing Practice Final Manuscripts

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM …

Increasing Access To Medications For Opioid Use Disorder For All Justice-Associated Populations, Edgar Rodriguez

Doctor of Nursing Practice Final Manuscripts

The purpose of this paper is to support a federal mandate requiring universal access to medication of opioid use disorder for all the justice-involved populations. The policy proposal aims to standardize evidence-based treatment across correctional systems, improve treatment initiation during incarceration, strengthen continuity of care after release, reduce overdose mortality, and address disparities in access for racial and economic groups and rural communities. This policy paper calls for the increase of access to medications of opioid use disorder across the United States for all justice-involved population. The opioid crisis has created a public health problem in the United States by …

Exploring The Role Of Self-Efficacy In Undergraduate Nursing Students: A Transcendental Phenomenological Study, Dorothy Elaine Rolling

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the role of self-efficacy for nursing students whose primary language was not English and who were enrolled in higher education in the northeastern area of the United States. The theory guiding this study was Bandura’s theory on self-efficacy. The major tenets of the self-efficacy theory aligned with the metaparadigm of nursing (person, health, environment, nursing) and with the study’s focus, which was to explore how English as a second language (ESL) nursing students could successfully complete the registered nursing program at an institution of higher learning. The central research question was: …

Managing Maternal Anemia In Pregnancy: The Role Of Iron-Rich Foods And Supplementation, Carli Dibler

InnovateHER Meeting 2026

Anemia during pregnancy is a large public health concern, which often leads to independent risk factors for fetal and maternal outcomes including postpartum hemorrhaging, cesarean sections, blood transfusions during and after the labor process, hysterectomies, preterm birth, and infectious diseases. Six level I-III studies were analyzed using the John Hopkins nursing evidence-based practice model. Findings showed that by using a combined approach of dietary intake and supplementation overall leads to better fetal and maternal outcomes compared to supplementation alone.

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …

Weighted Blankets: Implementation Of A Quality Improvement Pilot Project In The Neurosciences Intensive Care Unit, Anita Musafar

Doctoral Projects

The weighted blanket quality improvement pilot project was implemented at Stanford Healthcare (SHC) to address the limited number of nonpharmacological interventions available for agitation management in the critical care setting. Patients within the Neurosciences ICU (NSICU) at SHC are clinically complex and uniquely vulnerable to experiencing agitation. The objectives of this initiative were to understand nurses' perceptions surrounding weighted blanket use in the critical care setting and assess whether there was a decrease in Richmond Agitation-Sedation Scale (RASS) scores with this intervention. From September 2025 to December 2025, the nurses within the NSICU implemented the use of weighted blankets for …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Be Prepared For Your Nurse Practitioner Clinical Readiness Exam, Elizabeth Heavey, Renee Biedlingmaier, Colleen Burgoyne, Carnel C. Jackson

Milne Open Textbooks

This text contains case studies and review questions for nurse practitioner students; focusing on the 3Ps of nurse practitioner education (Pharmacology, Pathophysiology, and Physical (Health) Assessment) to help NP students prepare for their clinical courses and pass their clinical readiness exam.  It includes cases commonly seen in entry-level NP practice.  In addition to the three individual sections of the text that focus on cases applying content from each of the distinct courses (Pathophysiology, Pharmacology, and Physical Assessment), we included summative case studies at the end of the book that connect all three areas in a single case. Because these three …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Staff Education On Central Line-Associated Bloodstream Infection Prevention Bundle Practices, Ngowari Warmate

Walden Dissertations and Doctoral Studies

No abstract provided.

Beyond Cough Drops And Band-Aids: An Interpretive Phenomenological Study Of Certified School Nurses’ Professional Scope And Enacted Roles In Pk–12 Settings, Brandy Gershon

Electronic Theses and Dissertations

This qualitative dissertation explored the underutilization of certified school nurses (CSNs) in PK–12 educational settings across urban, suburban, and rural school districts in western Pennsylvania. Despite their advanced preparation and wide-ranging scope of practice, school nurses are often limited to providing episodic care, including first aid, medication administration, and treatment of minor injuries. This limited use reflects a significant misalignment with their professional scope of practice, which encompasses chronic disease management, health education, mental health support, care coordination, and leadership in public health. Guided by role theory (Biddle, 1986), this study examined how school nurses perceived and interpreted their professional …

Making Sense Of Hospitalization: An Interpretative Phenomenological Analysis Of Covid-19 Patients’ Psychological Experiences In Indonesia, Mira Wahyu Kusumawati, Heni Dwi Windarwati, Setyawati Soeharto

The Qualitative Report

While previous research has probed into the experiences of COVID-19 patients during isolation in hospitals, little is known about their psychological experiences and the meaning of such experiences. To address the gap,this study was designed to explore the psychological experiences of patients who were confirmed positive for COVID-19 while undergoing isolation in hospitals. Using a phenomenological approach, we recruited 19 COVID-19 survivors who were confirmed positive for COVID-19 in the first six months of the pandemic entering Indonesia, located in Madiun Regency, East Java Province, Indonesia. We conducted face-to-face semi-structured interviews with health protocols and analysed the data using the …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Barriers To Climate Change And Sustainability Action: Nursing Education And Practice, Dawn Marie Smith

Dissertations

Climate change is one of the most pressing public health emergencies of our time and nurses can have a great impact in their current practice and in the education of future nurses (The Alliance of Nurses for Healthy Environments, n.d.; American Nurses Association, 2023; Health Care without Harm, 2025). Deaths due to rising temperatures, vector-borne illness, and food insecurity related to drought and extreme weather are on the rise (WHO, 2024). It has been estimated that globally over 250,000 additional deaths will be attributed to climate related effects between 2030 and 2050 (Watts et al., 2020; WHO, 2023).

A primary …

Historical Development Of Vaccines And The Public's Response, Kristen Montgomery, Samantha Prince Bsn, Rn, Melissa Ealey Bsn, Rn, Jarrad Morelock Bsn, Rn, Shelby Johnson Bsn, Rn, Kokeshia Crosby Bsn, Rn, Stephanies Himes Bsn, Rn, Theresia Hinton Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Vaccines, which have become one of the most important medical accomplishments in the prevention of communicable diseases, have a history that dates to the use of variolation as early as the 11th century. The purpose of this study is to explore the historical development of vaccines and to determine the characteristics that emerged when new vaccines were developed.

Aims: The specific aim of this study is to understand if all vaccines have been received about the same by the general public or if there are certain different or diverse characteristics associated with the introduction of different vaccines.

Methods: A …

Improving Pneumococcal Immunization Counseling In Children With Systemic Lupus Erythematous, Sarah Dettmann

Doctoral Dissertations & Projects

Background: Pediatric patients with systemic lupus erythematosus (SLE) face elevated risk for invasive pneumococcal disease, yet fewer than 10% are estimated to be current on pneumococcal vaccine (PCV) recommendations.

Local Problem: This quality improvement (QI) project aimed to develop and implement a standardized pneumococcal immunization screening and counseling process in a pediatric rheumatology clinic.

Method: Three consecutive PDSA cycles guided implemention across a nine-week intervention period using a pre-post quasi-experimental design.

Interventions: A multicomponent strategy was employed, including a PCV decision algorithm, EHR Smart Phrase, PCP referral template, and patient education brochure.

Results: Pre-implementation PCV counseling was documented …

Quality Improvement Project: Enhancing Efficacy And Reducing Urine Contamination Through Simulation In The Ed, Kimberley Strong

Doctor of Nursing Practice Projects

Urine specimen contamination in emergency department settings contributes to diagnostic inaccuracies, unnecessary antibiotic use, increased healthcare costs, and decreased patient satisfaction. This quality improvement project evaluated the impact of a simulation-based educational intervention on staff knowledge, self-efficacy, and urine specimen contamination rates among emergency department nurses and patient care technicians with less than six years of clinical experience in a rural Texas hospital. The aim of this project was to enhance knowledge and self-efficacy while reducing contamination rates over a six-week period. The project was guided by Knowles’ Adult Learning Theory as the theoretical framework, supported by Lewin’s Change Theory, …

Staff Education To Improve Nursing Knowledge Of Catheter-Associated Urinary Tract Infection Prevention Practices, Maylin Fernandez

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice quality improvement project, I used a staff education intervention to address nursing knowledge gaps related to catheter-associated urinary tract infection (CAUTI) prevention in a large outpatient urology clinic in the southeastern United States. Registered nurses (N = 28) participated in a single, 45-minute, in-person education session comprising PowerPoint slides, facilitated discussion, and printed job aids based on national guidelines. I used a single-group pre-/posttest design to evaluate the effect of the intervention. The primary outcome was staff knowledge measured using a paper-based, 17-item knowledge test administered immediately before and after the session. The secondary …