Digital Commons Network^™

Atracurium And Rocuronium On Pain Score During Intravenous Injection, Suha Adel Qasim Al-Ani

Al-Esraa University College Journal for Medical Sciences

Background: The non-depolarizing muscle relaxant (NDMR) is generally used in anesthesia for facilitation of intubations and muscle relaxations. Nevertheless, pains during injections remain as significant concerns. Aim of the Study: The aim of the study was to compare levels of pain scores related to various types of NDMR (Atracurium and Rocuronium) during injections. Patients and Methods: This study was applied on (60) patients whose ages ranged between (18–65) years and underwent different surgical operations. Patients are categorized into two groups: (31) patients receiving IV Atracurium and (29) receiving Esmeron (Rocuronium) in different doses. Following IV injection of the drug, immediate …

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 …

The Pivotal Role Of Artificial Intelligence In Optimizing Pharmaceutical Formulation And Delivery, Ali Khidher Abbas, Mustafa M. Noori, Ibtihal Abdulkadhim Dakhil, Mohammed Hussain Al-Mayahy

Al-Esraa University College Journal for Medical Sciences

Artificial intelligence (AI) has emerged as a transformative technological paradigm within the pharmaceutical sciences, offering innovative and forward-looking solutions to surmount the inherent limitations associated with conventional drug development, formulation design, and therapeutic delivery systems. Traditional pharmaceutical methodologies frequently entail protracted development timelines, extensive experimental procedures, and substantial financial expenditures, particularly within the domains of formulation optimization and drug delivery design. The integration of AI-driven technologies – encompassing machine learning (ML), deep learning (DL), artificial neural networks (ANNs), and predictive analytics – has considerably accelerated pharmaceutical research by refining decision-making processes, alleviating experimental burden, and enhancing formulation efficiency. The present …

The Pathological Interaction Between Diabetes And Hypertension: Mechanisms And Clinical Complications, Alaa Al-Noori, Ayad Ahmed Al-Taweel, Qater Alnada Jassim Mohammed, Tarik Muhammad Ali, Majeed Mihsin B. Al-Hamdani, Noor Thair Tahir

Al-Esraa University College Journal for Medical Sciences

Among the most prevalent chronic conditions, diabetes and hypertension frequently coexist in a single patient, aggravating vascular problems and hastening the deterioration of target organs, especially the kidneys. By raising intraglomerular pressure, impairing endothelial function, and triggering oxidative stress and inflammation, hypertension directly increases the chance of developing diabetes sequelae, including diabetic nephropathy. Chronic kidney disease advances more quickly when poorly managed hyperglycemia and hypertension combine to cause a decrease in glomerular filtration rate and an increase in urine albumin excretion. Other consequences like retinopathy, neuropathy, and cardiovascular disease are also encouraged by this pathological occurrence. Reducing the advancement of …

Clinical Significance Of Liver Enzyme Biomarkers In Chronic Statin Users, Muayad Khaleel Ibrahim, Saad Mahmoud Saeed

Al-Esraa University College Journal for Medical Sciences

It is possible that statins, by their dual capacity to modulate (both stimulate and suppress) immune responses, could play a role in influencing the course of autoimmune diseases. Consequently, our investigation was designed to explore how statins impact both the innate and adaptive branches of the immune system, as well as their effect on the crucial mechanism of self-tolerance. This was achieved through the comprehensive measurement of various antibody profiles, specifically including the detection and quantification of autoantibodies, such as antinuclear antibodies and Creatinine kinase, Aldolase, HMGCR antibody, Albumin and Bilirubin and Alanine transaminase, Aspartate aminotransferase, Our investigation employed a …

Some Pathogenic Agents Isolated From Gento-Urinary Tract Of Females Patients In Baghdad Area, I. M. Al-Saqur, A. N. Al-Thwani, E. M. Abdul Ameer, S. W. Abd-Al-Zhra, M. K. Sahan, H. S. Ferman, A. A. Hassan, H. M. Hassan

Al-Esraa University College Journal for Medical Sciences

The Urinary Tract Infection (UTI) represents a significant global health burden and the pathogens which inhibit the geneto - urinary Tract (GUT) of women cause devastating consume. In this study investigation UGT were carried out through examination of 186 women (183 married and 65 unmarried) who attended Damascus Private Medical Center-Baghdad, through the period from the beginning of January 2023 to the end of August 2023. Detection were conducted according to the standard methods after macroscopically and macroscopically examination of u samples. The results, indicated that 121 (65.05%) were infected and married women had high infection (78.86%) than the unmarried …

Measuring The Concentration Of Heavy Metals In The Serum Of Traffic Police And Their Impact On Heart Disease In The Future, Hanaa Khalil Sacheat

Al-Esraa University College Journal for Medical Sciences

The spread of heavy metals such as lead, cadmium and nickel is a clear danger that threatens the earth and disrupts the ecological balance. In this research, we evaluated the danger of these metals present in the areas of traffic points for traffic policemen who are present for long periods at traffic points. 25 blood samples were collected from traffic policemen present at traffic points, with information about age, date of joining the job, and smoking, The comparison was made with the same number of samples of people who were in a job inside buildings, The results showed a significant …

Promoting The Hpv Vaccine Across The League Of Arab States: A Scoping Review Of Interventions, Basil H. Aboul-Enein, Patricia J. Kelly, Fatmah Almoayad, Teresa Keller

College of Nursing Faculty Papers & Presentations

INTRODUCTION: This scoping review examined existing interventions designed to promote and educate about HPV vaccination in the league of Arab states (LAS).

METHODS: Following PRISMA-ScR guidelines and using a PICOS-informed approach, a comprehensive search was conducted across 16 databases to identify peer-reviewed intervention studies published between 2010 and August 2025.

RESULTS: Twenty-two studies met the inclusion criteria. Most interventions originated from Egypt and Saudi Arabia and were delivered in academic or clinical settings using short, didactic, one-group pre-post designs. Only a few studies incorporated behavioral theories, digital modalities, or multi-component strategies. Nearly all studies reported short-term improvements in HPV-related knowledge …

Dnp Final Report: Enhancing Radiation Oncology Training For Advanced Practice Providers, Katherine A. Bukolt

DNP Final Reports

Background: Rising cancer incidence and improved survivorship are straining the oncology workforce, increasing reliance on Advanced Practice Providers (APPs). However, there is a lack of standardized educational resources for APP radiation oncology training across practice settings. Most APPs receive variable, resource-dependent, and on-the-job training. Evidence shows that the lack of standardized training leads to gaps in foundational knowledge, reduced confidence in toxicity management, inconsistent role development, and variable satisfaction with training and transition into practice.

Purpose: This quality improvement project evaluated the feasibility of implementing an 18-module Advanced Practice Radiation Oncology (APRO) asynchronous online curriculum to standardize APP radiation oncology …

Surviving Sepsis 2026: Key Updates, Amanda Rawa, Katherine Ghattas

Transformative Medicine

The 2026 update to the Surviving Sepsis Campaign guidelines introduces several important changes in the management of sepsis and septic shock, with a greater focus on tailoring treatment to individual patients. Notable updates include lower blood pressure targets for older adults with septic shock, continued support for early fluid resuscitation, the selective use of rapid diagnostic testing to guide antibiotic therapy, and increased flexibility in vasopressor selection for patients with cardiac dysfunction. These recommendations are based on emerging evidence aimed at improving patient outcomes while reducing unnecessary interventions and treatment-related complications. Overall, the updated guidelines reinforce a more personalized approach …

Quality Improvement Project: Improving Confidence And Clinical Judgment Through Simulation Remediation In Nursing Students, Erica Gillespie

Doctor of Nursing Practice Projects

Simulation is a critical component of nursing education, providing students with a safe environment to develop clinical judgment and confidence before entering clinical practice. However, students may experience anxiety and difficulty meeting competency expectations during simulation. This quality improvement project evaluated whether structured simulation remediation improved confidence and clinical judgment among associate degree nursing students. The project was guided by the NLN Jeffries Simulation Framework, and Kotter’s 8-Step Change Model supported implementation. A quantitative, quasi-experimental pre-/post- intervention design was used. Nine nursing students voluntarily participated. During remediation, students reviewed recordings of their initial simulation experiences and completed guided reflection questions …

The Effect Of The Covid-19 Pandemic On Diagnostic Testing Time Completion For African American End Stage Renal Disease (Esrd) Patients Being Evaluated For Kidney Transplantation, Kesha Levesque, Martina Mueller, Julie Anderson, Jennifer Gander, Gayenell Magwood Phd, Rn, Faha, Faan, Ahmed I. Kamal, Michael Jin Casey, Susan Newman Phd, Rn, Crrn, Faan

Publications

PURPOSE: The COVID-19 pandemic was directly associated with fewer additions to the kidney transplant waiting list and likely contributed to delays in transplant rates, particularly for African Americans. It remains unclear if the pandemic specifically had an impact on diagnostic testing time completion for African Americans being evaluated for kidney transplant waitlisting. AIMS: To examine the impact of the COVID-19 pandemic on kidney transplant diagnostic test completion time and assess racial disparities between African American and White patients. DESIGN: This retrospective study analyzed data on patients approved for kidney transplantation at a southeastern academic medical center between January 2018 and …

The Effect Of The Covid-19 Pandemic On Diagnostic Testing Time Completion For African American End Stage Renal Disease (Esrd) Patients Being Evaluated For Kidney Transplantation, Kesha Levesque, Martina Mueller, Julie Anderson, Jennifer Gander, Gayenell Magwood Phd, Rn, Faha, Faan, Ahmed I. Kamal, Michael Jin Casey, Susan Newman Phd, Rn, Crrn, Faan

Publications

PURPOSE:

The COVID-19 pandemic was directly associated with fewer additions to the kidney transplant waiting list and likely contributed to delays in transplant rates, particularly for African Americans. It remains unclear if the pandemic specifically had an impact on diagnostic testing time completion for African Americans being evaluated for kidney transplant waitlisting.

AIMS:

To examine the impact of the COVID-19 pandemic on kidney transplant diagnostic test completion time and assess racial disparities between African American and White patients.

DESIGN:

This retrospective study analyzed data on patients approved for kidney transplantation at a southeastern academic medical center between January 2018 and …

Topical Normal Saline, Alcohol, And Petrolatum For Marsi: A Randomized Controlled Trial, Michael Hartanto Angriawan, Shannaz Nadia Yusharyahya, Rahadi Rihatmadja

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Medical adhesive-related skin injury (MARSI) is a common complication associated with acrylic-based adhesive removal. Topical agents such as 0.9% NaCl (normal saline), white petrolatum, and 70% alcohol are commonly used to assist adhesive removal; however, their effectiveness in reducing MARSI remains unclear.

Methods: This single-blind randomized controlled trial with a within-subject design included 56 healthy adults. Acrylic-based adhesives were applied to four sites on the upper arms. Adhesive removal was performed on days 3 and 6 using three interventions (normal saline, petrolatum, alcohol) and one control (no topical agent). Outcomes included MARSI incidence, clinical erythema score, erythema index, transepidermal …

Behavior Change Techniques In A Care Partner–Assisted Oral Health Intervention For People With Mild Dementia: A Secondary Mixed-Methods Analysis, Jing Wang, Courtney Caiola, Chiao-Hsin Teng, Youngmin Cho, Zhijing Xu, Jackie Finik, Shahrzad Siamdoust, Ya-Ning Chan, Eunjung Ko, Justine Seidenfeld, Ayomide Okanlawon Bankole, Donald E. Bailey Jr, Cappye Mott, Bei Wu, Brenda L. Plassman, Ruth A. Anderson

School of Nursing Faculty Scholarship and Creative Works

Background and Objectives: Oral hygiene declines early in mild dementia (MD), yet few interventions specify which behavior change techniques (BCTs) drive improvement. We examined the use of BCTs in relation to oral health outcomes in a care-partner–assisted intervention for persons living with MD.

Research Design and Methods: Using a secondary convergent mixed-methods design, we analyzed the coaching arm of a three-arm randomized trial. Seventeen dyads (persons living with MD-care partners) completed four coaching sessions (68 coaching session transcripts). Seventeen BCTs were specified for use in the coaching manual. Transcripts were double-coded to denote frequency of BCTs used. Changes in the …

Quality Improvement Project: Impact Of Adjunct Clinical Faculty Mentorship On Self-Confidence: A Quality Improvement Project, Fairah Solomon

Doctor of Nursing Practice Projects

Novice adjunct clinical faculty transitioning from expert clinicians to nurse educators face many challenges, particularly in understanding their roles, responsibilities, and educational frameworks. Despite an established orientation at the project site, a structured mentorship program to support the role transition is lacking. This quality improvement (QI) project aimed to improve novice adjunct clinical faculty’s self-confidence through the implementation of a structured mentorship intervention. Guided by Lewin's Change Theory and Constructivist Learning Theory, the project utilized a quasi-experimental pre- and post-test design. Implementation was guided by the Plan-Do-Study-Act framework. A purposive sample of seven novice adjunct clinical faculty with less than …

Staff Education On Stress Management And Coping Strategies For Psychiatric Nurses, Chidinma Uwakwe

Walden Dissertations and Doctoral Studies

No abstract provided.

Critical Care Nurses’ Self-Efficacy In Responding To Emergency Code Situations, Nesheemah Sabree

Walden Dissertations and Doctoral Studies

No abstract provided.

Quality Improvement Project The Impact Of The Interact “Stop And Watch Tool” In A Skilled Nursing Facility, Lorraine Hicks

Doctor of Nursing Practice Projects

Avoidable hospitalizations from skilled nursing facilities (SNF) contribute to increased healthcare costs, resident distress, and adverse health outcomes. Many readmissions result from delays in identifying and communicating early signs of resident deterioration. The purpose of this project was to implement an evidence-based intervention to recognize early changes in residents’ conditions, empower nursing staff to detect and promptly communicate concerns, and impact 30-day hospital readmission rates. Problems identified included delayed recognition of early changes in residents’ conditions, fragmented staff communication, and the absence of standardized reporting practices, which were associated with preventable hospital readmissions. A quasi-experimental pre-/post-intervention design guided by Jean …

Enhancing Sleep Quality Through Sleep Hygiene Education Among Adults In A Faith-Based Community, Denielle Earle-Thompson

Doctor of Nursing Practice Projects

Background

Adults between 18 and 64 years of age require at least seven hours of sleep per night; however, many adults do not meet this recommendation, contributing to increased risks for chronic disease, impaired functioning, mood disturbances, and reduced quality of life. Poor sleep quality has been associated with weakened immunity, cardiovascular disease, diabetes, obesity, anxiety, depression, and decreased daytime performance. Obtaining adequate, good-quality sleep is essential for maintaining overall health and well-being. In faith-based communities, combining health education with spiritual support may provide a holistic approach that addresses both physical and emotional contributors to poor sleep.

Purpose

The purpose …

A Scoping Review Of Preventive Interventions To Reduce Violence Against Women And Girls In The Islamic Republic Of Iran, Wahiba Abu-Ras, Leena Babiker Idris, Shahira Amin, Ashley Butler, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

In Iran, violence against women (VAWG) remains highly prevalent, with reported rates ranging from 22.9% to 66%, underscoring the need for effective, contextually grounded interventions.   This scoping review aimed to systematically identify, map, and critically appraise intervention strategies addressing VAWG in Iran.   Guided by PRISMA-ScR and the PICOS framework, comprehensive searches were conducted across nine databases from 2000 to September 2024. Eligible studies included intervention-based research conducted in Iran that reported outcomes related to violence reduction, psychological well-being, or empowerment. Thirteen studies met the inclusion criteria.   The included studies demonstrated heterogeneous designs, theoretical frameworks, and outcome measures. Four interventions targeted …

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 …

Preparing Adjunct Clinical Instructors For Success: The Impact Of A Structured Orientation Program On Perceived Capabilities As Measured By The Capabilities Of Nurse Educators (Cone) Questionnaire, Amanda Stone

Doctor of Nursing Practice Projects

Adjunct clinical instructors are essential in helping nursing students connect classroom learning to real-world patient care. A needs assessment within an associate degree nursing (ADN) program identified that adjunct clinical instructors received only a brief overview of policies, contributing to role uncertainty and inconsistent preparation for clinical teaching responsibilities. Current literature supports the use of structured orientation and mentorship to better prepare nurses as they transition into clinical educator roles. The purpose of this quantitative, quasi-experimental quality improvement project was to evaluate the impact of a structured orientation program on adjunct clinical instructors’ perceived capabilities. Guided by the Plan-Do-Study-Act change …

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.

Nursing Staff Education On Transgender Patient Care In A Nursing Home, Cyril Shan Madera Tena

Walden Dissertations and Doctoral Studies

No abstract provided.

Implementation Of Standardized Mental Health Screening And Referral Protocols For Depression In Patients Aged 65 And Older In Primary Care Settings, Elizabeth Nyambura Irungu

Walden Dissertations and Doctoral Studies

No abstract provided.

Implementation Of A Standardized Adverse Childhood Experiences Screening Process In A Primary Care Clinic, Tanya M. Wonnacott

Doctoral Dissertations & Projects

Adverse Childhood Experiences (ACEs) are associated with increased risks of chronic disease, mental health disorders, substance use disorders, and premature mortality. Despite growing evidence supporting ACE screening, it remains inconsistent in many primary care settings, particularly among underserved populations. The purpose of this quality improvement project was to evaluate whether implementation of a standardized ACE screening workflow increased ACE screening completion and behavioral health referral within a nonprofit primary care clinic serving uninsured, underinsured, and refugee populations.

This project utilized a pre–post quality improvement design guided by Lewin’s Change Management Model and the Chronic Care Model. Interventions included standardized ACE …

Determinants Of Cardiovascular And Metabolic Noncommunicable Diseases Among People Living With Hiv In Rwanda: Protocol For The Ncohirwa Prospective Cohort Study, Valentine Dushimiyimana, Marc Twagirumukiza, Madeleine Durand, Ntobeko Ntusi, Brenda Asiimwe Kateera, Noella Bigirimana, Ladislas Nshimiyimana, Pacifique Ndishimye, Vivianne Niyonkuru Umuhire, Prosper Karame, Valens Ndagijimana, Joseph Mucumbitsi, Alfred Dusabimana, Cecile Ingabire, Yvonne Delphine Nsaba Uwera, Km Monirul Islam, Celestin Hategeka, Sabin Nsanzimana, Ernst Rietzschel, Steven Callens, Clarisse Musanabaganwa, Jean Claude Semuto Ngabonziza, Eric Remera, Jean Pierre Musabyimana, Claude Mambo Muvunyi, Albert Tuyishime, Gallican Nshogoza Rwibasira, Gregorie Muhorakeye, Simeon Tuyishime, Francois Uwinkindi, Evarist Ntaganda, Simon Pierre Niyonsenga, Noel Gahamanyi, Kayigi Etienne, Fidel Umwanankabandi, Theogene Kubahoniyesu, Alphonse Mbarushiman, Muhammed Semakula, Leopold Bitunguhari, Jean Damascene Kabakambira, Annette Uwineza, Marcellin Musabende, Felix Babane, Vincent Karamuka, Fidens Dusabeyezu, Alyson Kelvin, Pacifique Mukashema, Augustin Murindabigwi, Steven Karera, Katia Giguère, Godfrey Katende, Jean Berchmans Tugirimana, Deo Mutambuka

School of Nursing & Midwifery, East Africa

Background: Noncommunicable diseases (NCDs), particularly cardiovascular diseases (CVDs), hypertension and diabetes, are major contributors to morbidity and mortality globally and in Rwanda, where the dual burden of HIV and NCDs is increasing. Evidence remains limited on how biological, behavioural, social, environmental and health-system determinants influence cardiovascular and metabolic outcomes among people living with HIV (PLHIV) in Rwanda. The NCOHIRWA cohort was established to prospectively investigate determinants associated with CVDs, hypertension, diabetes and related NCD outcomes among PLHIV, newly diagnosed PLHIV and people without HIV (PWoH). This manuscript presents the protocol for the NCOHIRWA cohort study.

Methods:  The NCOHIRWA study …

Staff Education To Improve Knowledge On Delirium Assessment, Prevention, And Treatment, Michelle Lee Coll

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Nurses’ Knowledge Of Standardized Car, Relax, Alone, Forget, Friends, Trouble (Crafft) Screening In Outpatient Psychiatric Care, Linda Edeity

Walden Dissertations and Doctoral Studies

No abstract provided.