Digital Commons Network^™

Examination Of Maternal Mortality, Mental Health Conditions, And Co-Occurring Factors, Laura Eileen Skaarer

Walden Dissertations and Doctoral Studies

Maternal mortality (MM) continues to be a public health concern in the state of Arizona. There is little to no research investigating the relationship between MM and mental health conditions co-occurring with contributing factors among women who have died in Arizona while pregnant or within 1 year of the end of a pregnancy. The purposes of this quantitative study, guided by the three delays model (3DM), were to examine (a) MM and mental health conditions as the primary underlying cause of death; (b) MM and mental health conditions surrounding death; and (c) significant contributing factors (i.e., discrimination, knowledge, lack of …

Staff Education To Decrease Workplace Violence Through De-Escalation Training In The Emergency Department, Tyrani Anderson

Walden Dissertations and Doctoral Studies

Workplace violence remains a significant issue in healthcare settings, particularly in emergency departments where psychiatric patients may present with aggressive behaviors. Nurses and healthcare staff are frequently exposed to verbal threats, intimidation, and physical aggression, which negatively impact staff safety, job satisfaction, and patient care quality. Despite workplace violence prevention policies, gaps remain in staff preparedness when managing escalating patient behaviors. The purpose of this Doctor of Nursing Practice project was to implement an evidence-based de-escalation training program to improve staff knowledge about managing aggressive psychiatric patients in the emergency department. The practice- focused question was: Can staff education on …

A Charism-Based Faculty Instruction Framework For Nursing Education: Integrating Values-Driven Pedagogy In Blended Learning Environments, Humprey G. Icban, Anele C. Mallari, Cherry B. Lazatin, Aurora R. Valencia, Lilibeth G. Sales, Ulysses J. Rengel, Marie Aileen L. Domingo

The Journal of Faith, Education, and Community

The evolution of nursing education in the Philippines is driven by dynamic global healthcare demands and an accelerated shift toward blended learning modalities. The central challenge lies in preserving the humanistic values of compassion and integrity within technology-mediated environments. This study addresses this issue by developing a Charism-Based Faculty Instruction Framework (CBFIF) designed to empower clinical instructors at the University of the Assumption College of Nursing and Pharmacy (UACONP) in their crucial role as "Formators of Catholic Leaders." The framework is intended to cultivate the institution's core graduate attributes: "Biasa" (academically competent), "Maganaca" (morally upright), and "Mayap" (socially responsible). A …

Nurses’ Knowledge And Practices Regarding Infection Prevention Measures In Cardiac Intensive Care Unit, Marwa G. Abouheiba, Maha Adel Salem, Jean Bertin Mudenge

Nursing

Abstract: Background: Healthcare-associated infections (HAIs) remain a major global patient safety challenge, contributing substantially to morbidity, mortality, prolonged hospitalization, antimicrobial resistance, and increased healthcare costs. Patients admitted to cardiac intensive care units (ICUs) are particularly vulnerable because of their critical illness, frequent exposure to invasive devices, and complex cardiovascular interventions. Nurses play a pivotal role in preventing HAIs through the consistent implementation of evidence-based infection prevention and control (IPC) measures. Therefore, assessing both nurses' knowledge and their observed clinical practices is essential for identifying strengths, potential gaps, and opportunities for quality improvement. Aim: To assess nurses' knowledge and observed practices …

Enhancing Nursing Competency In The Ambulatory Surgery Center, Rachael Owokole

Walden Dissertations and Doctoral Studies

In this project, I addressed a persistent practice problem among agency nurses working in an ambulatory surgery center (ASC) in Southern California, who often enter the facility with varying familiarity with its policies and procedures. I designed this staff education, evidence-based practice (EBP), quality-improvement initiative to strengthen nursing knowledge and competency among agency nurses at the facility. The practice question was designed to assess on whether their knowledge and self-perceived competency improved after participating in the education program. I obtained evidence for the project from peer‑reviewed research, clinical guidelines, and national competency frameworks. I identified sources through systematic searches of …

Staff Education To Instruct Nurses On How To Use The Braden Scale To Increase Their Knowledge, Anna Shedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

Influence Of Dietary Protein On Levodopa Effectiveness, Meghan Decker Rn

Nurse Residency

In adult patients with Parkinson's disease how does carbidopa-levodopa administration with protein vs without protein impact levodopa absorption and patient signs and symptoms?

Improving Patient And Staff Safety During Intrahospital Transport: Implementation Of A Nurse-Driven Checklist, Leah D. Kvintus Rn, Bsn

Nurse Residency

In hospitalized adult patients requiring intrahospital transport, how does the implementation of a standardized nurse-driven transport checklist and structured, facility-wide transport safety protocols compared to current practice without standardization affect patient and staff safety outcomes, including patient falls, safety incidents, and staff injuries or workflow disruption?

Why 4:1 Matters: Addressing Nurse Burnout, Alexandria Ranalletti Bsn Rn, Cecelia Greenleaf Bsn, Rn, Savannah Sheen Bsn, Rn

Nurse Residency

For nurses on medical-surgical floors, how does implementing a 4:1 nurse-to-patient staffing ratio compared to 5:1 or 6:1 staffing ratios impact nurse burnout?

Fall Prevention Education Among Older Adults At Townson Assisted Living Facility (Talf), Yolana Farrell-Williams

Walden Dissertations and Doctoral Studies

Falls in the elderly are a significant cause of injury, disability, and preventable medical expenditure; thus, fall prevention is an issue to assisted living homes like Townson Assisted Living Facility (TALF). The internal incident reports showed that persistent fall incidents were associated with inconsistent knowledge among the staff and unequal observed compliance with fall-prevention guidelines, indicating a practice gap in the systematized education of nurses. Educational interventions are effective in achieving high-quality staff, adherence to protocols, and outcomes concerning falls. Consequently, the current project was conducted to determine whether a specialized falls-prevention education program would enhance the knowledge and competency …

Educating School Nurses On Trauma-Informed Care, Na-Keisha Allene White

Walden Dissertations and Doctoral Studies

Trauma-informed care is a critical component of supporting students' overall wellness, and school nurses are central to this work. They are often the first professionals to recognize when a student is exhibiting a trauma response or experiencing a mental health concern during the school day. Although evidence-based school health organizations have advanced efforts to ensure that academic environments are prepared to support students’ mental health needs, school nurses are too often left out of these strategic planning processes. Their exclusion not only overlooks their clinical expertise but also weakens the school’s ability to respond effectively and holistically to student needs. …

Effect Of Virtual Reality Intervention Of Postoperative Pain In Pediatric Surgical Patients, Tara L. Kempker

Dissertations

Problem: Pediatric surgical procedures are associated with preoperative anxiety. Preoperative anxiety is associated with higher postoperative pain. Multiple studies have found that decreasing preoperative anxiety using Virtual Reality (VR) Intervention also decreases postoperative pain scores and use of rescue analgesics in postoperative care units (PACU). However, there is no standardized protocol for use of VR interventions and in our institution, VR was not utilized at all.

Methods: This quality improvement (QI) initiative utilized a quasi-experimental design and convenience sampling. Quantitative data was collected during visits for scheduled operative visits for pediatric surgical patients ages seven to 18 years …

Psychotropic Medication Use In Older Adults In A Long-Term Care Facility: Implications For Screening Tool, Callie M. Johnson

Dissertations

Psychotropic medication use in older adults aged 65 years and older residing in the long-term care facility has a complex issue in the high use of psychotropic medications. Older adults residing  in long-term care (LTC) facilities are affected and prescribed at least one psychotropic or antidepressant medication.

Enhancing Well-Being: Implementing Weekly Social Interventions For Older Adults In Independent Living, Rosa Huang

Dissertations

Loneliness and social isolation significantly impact the physical and mental well-being of older adults. This quality improvement project implemented an eight-week social intervention designed to reduce loneliness and enhance well-being through weekly sessions incorporating mindfulness exercises, gratitude journaling, and structured socialization activities. The intervention was delivered by nursing students to a sample of residents in a Midwestern independent living community. While most standardized measures of loneliness and mood did not show statistically significant changes, the project resulted in a statistically significant increase in social network engagement as measured by the Lubben Social Network Scale-6 (LSNS-6). The findings suggest that group-based …

Clinical Practice Guideline For Evidence-Based Management Of Chronic Prostatitis, Sandra Castro

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project involved the development, expert appraisal, and implementation of an evidence-based Clinical Practice Guideline (CPG) for chronic prostatitis management in adult male patients at a private outpatient clinic. The practice problem was persistent symptom burden from reliance on antibiotic monotherapy without adjunctive therapies, contributing to recurrent symptoms and decreased quality of life. The purpose was to develop and implement a standardized CPG to improve symptom outcomes and support antimicrobial stewardship. The project question was: In adult male patients with chronic prostatitis, how does a standardized CPG incorporating adjunctive ozone therapy and structured symptom monitoring, …

The Effect Of Mindfulness-Based Interventions On Stress Resilience And Wellbeing Among Graduate-Level Nursing Students: An Integrative Review Across Disciplines, Delia Linch

Loma Linda University Electronic Theses, Dissertations & Projects

Background

Graduate nursing students frequently experience significant academic, clinical, professional, and personal demands that contribute to stress, burnout, and psychological distress. Mindfulness-based interventions have emerged as a potential strategy for promoting well-being and resilience among healthcare learners.

Purpose

The purpose of this integrative review was to examine the effects of mindfulness-based interventions on stress, burnout, resilience, and emotional regulation among graduate nursing students.

Methods

An integrative review was conducted using the Whittemore and Knafl methodology. Literature searches were performed in CINAHL, PsycINFO, and PubMed for studies published between 2000 and 2025. Primary research studies examining mindfulness-based interventions among graduate nursing …

Pressure Injury Prevention Bundle Implementation In An Acute Care Unit, Hannah K. Pobi

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Improving Medication Reconciliation Compliance In Home Health Admissions, Paula A. Petrie-Rivas

All Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Clinician compliance with medication reconciliation at a home health agency was below regulatory expectations, with agency performance significantly lower than state and national averages. Workflow inefficiencies, inconsistent clinician practices, and limited training contributed to noncompliance, increasing the risk of medication discrepancies, preventable rehospitalizations, and Medicare reimbursement penalties.

Aim: This quality improvement project implemented a standardized medication reconciliation workflow using the Agency for Healthcare Research and Quality’s MATCH toolkit to improve clinician compliance during admission to home health.

Evidence: Literature supports structured medication reconciliation as an effective strategy to improve safety during transitions of care. The MATCH toolkit provides a …

The Impact Of Hypertensive Disorders Of Pregnancy On Cognitive Outcomes In Offspring: Systematic Review And Meta-Analysis, Berihun Dachew, Tusa, Getinet Ayano, Kim Betts, Amanuel Gebremedhin, Daniel Rudaizky, Gizachew A. Tessema, Rosa Alati

Research outputs 2022 to 2026

Purpose To synthesis the available research on the association between hypertensive disorders during pregnancy (HDP) and adverse cognitive outcomes in children. Methods PubMed, MEDLINE, Embase, Scopus, CINAHL, and PsycInfo were searched from inception to February 2026 to identify relevant studies. Effect estimates and 95% confidence intervals (CIs) were extracted and pooled using inverse variance–weighted random-effects meta-analysis. Results Thirty-nine observational studies published between 1982 and 2026, covering over 12.5 million mother-offspring pairs, were included in the final analysis. The findings indicate that HDP were associated with a 39% increased risk of Intellectual Disability (ID) (OR = 1.39, 95% CI = 1.30–1.47) …

Digital Teaching In Midwifery Education Since 2021: A Literature Review Of Trends, Technological Advancements And Challenges, Michelle Gray, Kristina Vogel, Annette Bernloehr, Terri Downer, Melanie Welfare, Nicola H. Bauer

Research outputs 2022 to 2026

Aim: To produce an updated synthesis of digital learning and teaching approaches in midwifery education since 2021. Background: Globally, there is an increasing trend towards using digital technologies in midwifery education with little examination of trends, terminology or impact by midwifery academics. Design: A comprehensive literature review. Methods: Ten databases were searched (2021–March 2025) guided by JBI methodology and PRISMA-ScR reporting, resulting in 36 empirical studies focusing on digital technologies used with midwifery students. The review mapped recent technological developments, associated benefits and emerging challenges. Results: Digital innovations were in 15 countries and ranged from immersive virtual reality, augmented and …

Nursing Students' Evaluation Of Primary Health Care Clinical Placements - A Cross-Sectional Study, Debbie Procter, Megan Lee, Debbie Massey, Kylie Mccullough, Karen Strickland

Research outputs 2022 to 2026

Aim: Evaluate quality and satisfaction of nursing students' Primary Health Care clinical placements. Background: There is growing recognition of the need to expand the Primary Health Care nursing workforce, with positive clinical placement experiences considered essential for preparing and inspiring future careers in these settings; however, few graduate nurses choose this career path. Design: A cross-sectional study design using purposive sampling. Participants: Data were sourced from National Placement Evaluation Centre's 2023/2024 dataset using the validated PET–Nursing survey. The tool includes 20 items across two subscales - Clinical Environment and Learning Support, with the final item assessing overall placement satisfaction. Surveys …

Effects Of Targeted Interventions On Hiv Testing, Knowledge And Sexual Risk Behaviours Among Long-Distance Truck Drivers: A Systematic Review And Meta-Analysis, Cyrus Mutie, Berrick Otieno, Kawira Kithuci, John Gachohi, Grace Mbuthia

School of Nursing & Midwifery, East Africa

Objectives We aimed to systematically summarise and quantify the empirical evidence on targeted interventions and their effects on various HIV prevention outcomes for long-distance truck drivers (LDTDs) globally.

Design A systematic review and meta-analysis.

Data sources We searched PubMed, PubMed Central (PMC), Cumulated Index to Nursing and Allied Health Literature (CINAHL), ProQuest Central, EBSCOhost, ScienceDirect, World Health Organisation (Global Index Medicus), Cochrane Library, Scientific Electronic Library Online (SCiELO), Japan Science and Technology Information Aggregator, Electronic (J-STAGE) and China National Knowledge Infrastructure (CNKI) up to 15th May 2026.

Eligibility criteria We included original peer-reviewed interventional studies involving LDTDs of either gender …

Climate Change Education For Environmental Sustainability In Health Professions Education: A Modified Delphi, Moses Mutua, Mirriam Kivuva

School of Nursing & Midwifery, East Africa

No abstract provided.

Enhancing Colonoscopy Effectiveness: The Impact Of Split Dose Bowel Preparation, Samantha Balestrieri Bsn, Rn

Nurse Residency

In patients undergoing screening colonoscopies, does a split-dose bowel preparation regimen, compared with a standard single-dose regimen, result in improved colonic visualization and adenoma detection?

Optimizing Nursing Management Of Alcohol Withdrawal In The Emergency Department: A Comparison Of Benzodiazepines And Phenobarbital, Brook Kulis Bsn, Rn

Nurse Residency

In adult patients presenting to the emergency department with alcohol withdrawal syndrome, how does phenobarbital treatment compared with benzodiazepine-based treatment protocols affect emergency department and hospital length of stay, medication requirements, rates of hospital readmission, and overall patient outcomes?

Improving Patient Outcomes Through Nurse-Led Care Coordination, Anna Berry Rn

Nurse Residency

In patients admitted to the hospital, how does nurse-led care coordination compared to none, or patient reliance alone, impact better patient outcomes, better medication management and reduce hospital readmissions?

The Impact Of Emergency Nurse Experience On Triage Accuracy During High-Volume Emergency Department Shifts, Grace Littlefield Rn, Mia Cianchette Rn, Benjamin Drummey Rn, Charles Stever Rn

Nurse Residency

PICOT Question: In adult emergency department patients, how does assigning an experienced emergency room nurse to the triage role compared to assigning a less experienced nurse improve triage accuracy rates during high-volume shifts?

Manual Blood Pressure Readings Versus Automatic Blood Pressure Readings, Logan Delano Rn, Rae Hebert Rn, Hannah Rogers Rn

Nurse Residency

In patients under 60, how does manual blood pressure readings compared to automatic blood pressure readings affect the treatments received in a single hospital admission?

Fall Tailoring Interventions For Patient Safety: A Program Evaluation, Shirley Morrison

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls with injury rates had increased for over two years at the project hospital until nurse leaders implemented a new fall-prevention intervention. Patient falls are the most common preventable adverse event in acute care hospitals, with approximately 700,000 to 1 million occurring annually in the United States. Before implementing the Fall Tailoring Interventions for Patient Safety (TIPS) toolkit, the hospital’s program lacked an evidence-based approach and a fall communication board to alert staff, patients, and families about the individual fall risk status, leaving a significant gap in patient-centered care.

Aim of the Project: The aim of the project was …