Digital Commons Network^™

Enhancing Shared Decision-Making In Mental Health Care: A Quality Improvement Initiative, Joanna L. Hysler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is an evidence-based approach that enhances patient engagement, treatment adherence, and clinical outcomes in psychiatric care. Despite strong support in the literature, SDM remains inconsistently implemented in mental health settings due to limited provider training, time constraints, and organizational barriers. The purpose of this Doctor of Nursing Practice quality improvement project was to implement and evaluate an educational intervention designed to improve SDM utilization and provider confidence within a private outpatient psychiatric practice. The project was guided primarily by the Plan-Do-Study-Act framework to support structured practice change, with Lewin’s Change Theory providing additional conceptual support. The intervention …

Staff Education To Improve Knowledge Of Evidence-Based Engagement Strategies To Reduce No-Show Rates, Jerrica Luster

Walden Dissertations and Doctoral Studies

High no-show rates in outpatient mental health settings remain a persistent barrier to effective care delivery, negatively affecting continuity of care, patient outcomes, and access to services. In the identified practice setting, inconsistent use of evidence-based engagement strategies beyond standard reminder practices contributed to missed appointments. The purpose of this Doctor of Nursing Practice project was to evaluate whether a structured staff education intervention on evidence-based engagement strategies would improve staff knowledge as a foundation for enhancing appointment adherence. A quantitative pre- and posttest design was used to evaluate knowledge change following the intervention. Participants included outpatient mental health clinic …

Community-Based A1c Screening Initiative To Improve Diabetes Risk Identification Among People Experiencing Homelessness, Rebecca Drake, Deedee Long, Mariita Carter

Student Works

Abstract

Purpose: People experiencing homelessness (PEH) experience high rates of undiagnosed diabetes yet face significant barriers to preventive screening. This quality improvement project aimed to improve access to diabetes screening for PEH through on-site hemoglobin A1C (A1C) testing in a trusted community setting.

Methods: On-site A1C screening was implemented at the Utah County Food and Care Coalition (F&CC) using a low-barrier, community-based approach. Screening was conducted during routine service hours and integrated into existing workflows. Process, outcome, and balancing measures were used to evaluate feasibility, reach, and unintended effects.

Results: The intervention primarily supported identification of diabetes risk and referral …

Nurse Education On Nonpharmacological Management Of Knee Osteoarthritis, Toyin Mary Ajayi

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project aims to fill the gaps in the management of knee osteoarthritis (OA) in adults aged 40 to 75 years in a primary care practice. Knee OA is a common chronic disease that significantly impacts pain, mobility, and quality of life. Although there is empirical evidence that nonpharmacological interventions, including exercise, weight control, and self-management education, are effective, these methods are not consistently used in clinical practice, and pharmacologic treatment continues to be used. The project was designed to inform healthcare personnel about evidence-based nonpharmacological strategies to improve patient outcomes and reduce reliance on …

Staff Education On Early Sepsis Recognition For Medical-Surgical Nurses In The Acute Care Setting, Nadine Nzenga Udom

Walden Dissertations and Doctoral Studies

In this staff education project, I targeted early sepsis recognition and response among medical-surgical nurses. The practice gap at the site was nurses’ limited knowledge of sepsis indicators and screening tools, which contributed to delayed escalation of care. The practice-focused question guiding the project was “Does educating medical-surgical nurses on early sepsis recognition and response improve knowledge of early sepsis recognition and response?” I applied the analysis, design, development, implementation, and evaluation (ADDIE) and Johns Hopkins Evidence-Based Practice (JHEBP) models to design a structured sepsis education program for nursing staff. I searched for peer-reviewed literature via databases accessed through the …

Evaluating Mental Health Providers’ Knowledge And Attitudes Towards Stigma Among Teenagers Aged 13 To 19 Years With Mental Illness, Fredrica Murray Johnson

Wisdom & Compassion: The LUSON Journal

Limited knowledge and poor attitudes among mental health providers contribute to stigma towards individuals with mental illness, adversely affecting treatment experience and outcomes. This study evaluated the effectiveness of an educational intervention in improving mental health providers’ knowledge and attitudes toward stigma-based practices. The clinical question stated: Among mental health providers, does an educational intervention, compared to standard practice, improve knowledge and attitudes of stigma and promote evidence-based care delivery to adolescents aged 13 to 19 with mental illness within six weeks? The Iowa Model of Evidence-Based Practice (EBP) was the framework used to implement the quasi-experimental study. The two …

Non-Alcoholic Fatty Liver Disease, Diet And Contributing Factors: A Narrative Literature Review, Rachel Joseph, Ashley Tharpe, Sherri Ann Walker

Wisdom & Compassion: The LUSON Journal

Objectives: The purpose of this narrative literature review is to explore the relationship between Non-alcoholic fatty liver disease (NAFLD) and dietary habits, and identify factors that contribute to the development, progression, and potential management of NAFLD.

Methods: Search terms such as non-alcoholic fatty liver disease (NAFLD), diet, and nutrition, including plant-based and vegetarian diets, were used to identify 45 peer-reviewed publications published within the last five years.

Results: Dietary factors, biological, environmental, obesity, mental health, and genetic factors can contribute to the development of NAFLD. This multisystem problem can have economic, social, and psychological consequences that affect a person’s quality …

Resilience In Nursing Education: A Literature Review Examining The Experiences Of Ukrainian Nursing Students In The United States, Katherine Ferrell, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

The purpose of this literature review is to examine the experiences of international students who originate from war-torn areas, who live in the United States (US). Drawing from peer-reviewed sources, the review examines the academic, psychological, and social challenges these students face, including trauma, cultural adjustment, and gaps in institutional support. It highlights the resilience and coping strategies employed by students, as well as the role of universities in fostering inclusive environments. The review also identifies critical gaps in current research, particularly regarding long-term mental health outcomes and culturally responsive support services. This paper aims to synthesize existing literature on …

Navigating Life And Death: A Moral Critique Of Euthanasia Practices Worldwide, Brooke Fuzie, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

Euthanasia and physician-assisted death remain deeply debated ethical issues shaped by history, law, and cultural values. This narrative review explores how diverse ethical frameworks, shifting global legislation, and cultural perspectives inform current discourse, with special attention to the role of nurses guided by the American Nurses Association (ANA) Code of Ethics. Drawing on peer-reviewed studies, legal documents, and recent case analyses published between 2013 and 2025, the review identifies three key insights. Ethical frameworks influence whether society accepts or opposes euthanasia; robust legal safeguards are needed to protect autonomy and prevent misuse; and palliative care and advance care planning, including …

Perceived Knowledge, Attitude, Practice, And Barriers Of Jordanian Nursing Faculty To Integrate Genomic Concepts In The Curriculum: A Cross-Sectional Descriptive Study, Rachel Joseph

Wisdom & Compassion: The LUSON Journal

Background: Rapid advances in genomics knowledge and the expansion of precision medicine have amplified expectations for nurses to integrate genomic concepts into education and clinical practice. Evidence regarding genomic knowledge, attitudes, practices, and barriers among nursing faculty in the Middle East is limited. To equip practicing and emerging nurses, faculty must be equipped. Faculty preparedness is critical to successful curriculum integration and to preparing future nurses for genomic-informed care.

Purpose: This study examined the perceived knowledge, attitudes, practices, and barriers related to integrating genomic concepts in the nursing curriculum among nursing faculty in Jordan.

Methods: A cross-sectional descriptive design was …

More Than Machines: Our Identity In Christ, Jerrod A. Boggs

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Volume 3, Issue 2 - Complete Issue

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Public Health Book Club, Ashia Meister, James W. Durst, Ameila Beyer, Kelly K. Freymiller, Julia I. Kunz, Jaci M. Winchell, Josephine M. Sandquist, Chloe F. Sand

Research & Creative Achievement Day

Introduction: This project describes the development and implementation of a book club focused on population health topics to promote learning, discussion, and community engagement. A public library is a safe space to host book club meetings due to its non-intimidating environment. All members of the community are welcome to participate. A book club was hosted on campus for members of the nursing cohort to attend. With a focus on public health, these book clubs build awareness, critical thinking, and community engagement around population health issues. Purpose: The promotion of a book club can improve health literacy in the community by …

Treating Depression With L-Methylfolate: A Review Of Evidence, Marianna G. Pettit

Epsilon Sigma at-Large Research Conference

Abstract

Introduction & Background: Depressive disorders have many different causes. Folate deficiency can sometimes be behind these disorders, due to this vitamin’s role in neurotransmitter synthesis. Some research suggests that supplementing with an active form of folate improves depressive symptoms with and without antidepressant use. Purpose Statement Question: For individuals with depressive disorders, does supplementation with L-methylfolate (LMF) reduce symptoms of depressive disorders with or without use of an antidepressant? Literature Review: A manual literature search for sources published within the past 7 years revealed 557 documents from four different databases. Key search words included, “depression,” “treatment,” …

A Historical Analysis Of The Development Of Prenatal Care In The U. S., Kristen Montgomery Phd, Cnm, Aprn, Shelby Greene Bsn, Rn, Lauren Griffin Bsn, Rn, Destiny Lewis Bsn, Rn, Lauryn Lewis Bsn, Rn, Bryleigh Newberry Bsn, Rn, Brittany Scott Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: This paper examines the historical development of prenatal care in the United States, tracing its evolution from informal, home—based management to structured, evidence-based systems that are central to maternal and fetal health.

Aims: The specific aim of this project was to determine how prenatal care evolved in the United States.

Methods: A historical methods approach was used. Historical documents were reviewed using PubMed, CINAHL, and Google Scholar to find relevant resources. Relevant articles were reviewed by the research team and analyzed for components regarding the development of prenatal care. All members of the research team reviewed the articles and …

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 …

A Systematic Literature Review On Alternative Treatment Modalities In Adults With Treatment Resistant Depression, Brian Miller

Epsilon Sigma at-Large Research Conference

Abstract

            Currently, Psychiatric Mental Health Nurse Practitioners (PMHNPs) often defer to electroconvulsive therapy (ECT) for individuals with TRD who fail to achieve resolution of their disorder. However, many individuals do not meet criteria for ECT or decline the treatment due to side effects and associated risks. To synthesize potential alternative treatments and address the current gap in literature that does not include first-line preferred electroconvulsive therapy (ECT), a systematic literature review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA 2020). Databases searched for this review included the Cumulative Index to Nursing and Allied Health Literature …

Mindfulness-Based Therapy For The Treatment Of Anxiety In Adolescents, Alicia Lemaster

Epsilon Sigma at-Large Research Conference

Abstract

Adolescent anxiety disorders represent a significant and growing public health concern, with increasing prevalence and associated functional impairment. Traditional treatments, including cognitive behavioral therapy (CBT) and pharmacologic interventions, are effective but often limited by barriers such as access, stigma, and adherence. Mindfulness-based interventions (MBIs) have emerged as a promising alternative or adjunctive approach to address anxiety symptoms in adolescents. The purpose of this literature review is to evaluate the effectiveness of structured mindfulness-based therapy programs in reducing anxiety symptoms among adolescents compared to usual care. A systematic literature search was conducted using databases including PubMed, CINAHL, and PsycINFO, focusing …

A Systematic Literature Review Examining Suicide Risk Factors In Older Adults, Carolyn Bivens

Epsilon Sigma at-Large Research Conference

Introduction & Background: Suicide in older adults is a increasingly prevalent tragedy worldwide, and rates in North America have uniquely increased over the past two decades. The context of the cultural environment of North America and population-specific factors in the elderly must be explored to protect this vulnerable group.

Purpose Statement Question: In older adults living in North America, what experiences and risk factors influence the development and severity of suicidal thoughts and behaviors?

Literature Review: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart guided the search of the Cumulative Index to Nursing and Allied Health Literature …

Postpartum Psychosis Risk In Women With Bipolar Disorder, Rachel R. Lay

Epsilon Sigma at-Large Research Conference

Psychiatric relapse and postpartum psychosis pose vital psychological threats to women with bipolar disorder. The phase after delivery implies a great number of biological, psychological, and social alterations that might predispose to mood fluctuations and extreme psycho-psychiatric behavior. A systematic literature review assessed the recent literature on postpartum relapse risk, contributors, and maternal outcomes in women with bipolar disorder. Systematic search of three electronic databases, CINAHL, PubMed, and PsycINFO, revealed 168 studies dating back to 2022. Title and abstract screening of 124 articles was carried out after elimination of duplicates and other eligibility criteria. Eighteen articles were full-text reviewed, and …

Adolescent Depression, Telepsychiatry, And Access, Dustin Strickland

Epsilon Sigma at-Large Research Conference

Adolescent depression is prevalent, undertreated, and associated with long-term morbidity if left untreated. Several structural barriers impede timely access to specialty mental health care in this age group. Telepsychiatry, including therapist delivered videoconference psychotherapy and internet delivered cognitive behavioral therapies (ICBT) have been developed to expand access and continuity of care for adolescents. This modality, however, has not been thoroughly evaluated to determine the effectiveness of telepsychiatry in improving access to services and its ability to reduce depressive symptoms in adolescence. A structured literature review identified six primary studies and four complementary systematic reviews evaluating this topic. Randomized trials show …

Building The Nursing Leadership Pipeline: Outcomes Of A Statewide Emerging Nurse Leader Fellowhip, Kathleen Kinser Dnp, Aprn, Belinda J. Fleming Phd, Christie Manasco Phd, Monaco M. Briggs Edd, Yan Cao Phd, Jennifer Hitt Phd

Epsilon Sigma at-Large Research Conference

Healthcare systems increasingly require skilled nurse leaders to address workforce shortages, quality improvement demands, and complex care environments. However, many nurses transition into leadership roles without formal preparation. In this quality improvement project, nurse scientists Kathleen Kinser DNP; Belinda Fleming, PhD; and Christie Manasco, PhD, from the Tennessee Center for Nursing Advancement (TCNA) evaluated outcomes of the Emerging Nurse Leader Fellowship developed to strengthen foundational leadership competencies among novice nurse leaders. Guided by transformational leadership theory, the fellowship was a statewide, cohort-based, instructor-led, asynchronous online program emphasizing practical leadership development and application in clinical settings. Two cohorts participated and completed …

Association Of Self-Efficacy, Preceptor Teaching, And Role Modeling With Practice Preparedness In Student Nurse Practitioners, Quinton Carroll, Pi-Ming Yeh, Jean Croce Hemphill, Melessia Webb, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

Purpose: Final-semester student nurse practitioners (SNPs) often report unpreparedness for practice. Little is known about which preceptor characteristics prepare students for practice. The purpose of this study was to examine whether final-semester SNPs' practice preparedness is associated with their self-efficacy and most significant preceptor’s clinical teaching effectiveness and role modeling.

Aim: To identify which student and preceptor factors are associated with and predict SNP preparedness.

Methods: Cross-sectional correlational study of final-semester SNPs (N = 83). Participants completed the New Nurse Practitioners’ Practice Preparedness Survey, New General Self-Efficacy Scale, Cleveland Clinic Teaching Effectiveness Instrument, and Role Model Apperception Tool. Analysis …

A Historical Study Of The Nursing Role, Kristen Montgomery, Jessica Aranda Bsn, Rn, Amanda Dalton Bsn, Rn, Machea Scott Bsn, Rn, Lisa Desantis Bsn, Rn, Halle Hilton Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Historically, nurses have been at the bedside simply following the direction of physicians, but much has changed since then.

Aims: The purpose of this study is to examine how the roles of nurses have changed over the decades, from pre-professional caregiving to advanced practice. This study focuses on the birth of nursing as a profession, the direct experiences of nurses from different generations, the shift in physician-directed care to collaborative care, how nurses interpret the impact of major healthcare transformations on their role, and the emergence and development of the nurse practitioner role.

Methods: The study was conducted using …

Using Path Analysis To Examine The Psychological Well-Being Model For U.S. College Students, Pi-Ming Yeh, Cheng-Huei Chiao, Gavin Waters

Epsilon Sigma at-Large Research Conference

Background: College students’ psychological well-being and mental health issues are very important in this society. Little is known about a comprehensive psychological well-being model for college students.

Purpose: The purpose of this study was using Path Analysis to examine the Development of Personality and Psychological Well-Being Model among US college students.

Methods: This was a cross sectional, descriptive design. The 481 participants were recruited from nursing and business college students in the United States. After IRB approval, the trained researchers explained this study to college students. After agreeing to participate, they signed an informed consent form. Upon completion of a …

Restoring Moral Imagination: A Pilgrimage Of Ethical Formation In Prelicensure Nursing, Hannah Dube, Francesca Kearns

Student Posters & Conference Presentations

No abstract provided.

Health Is Where The Huddle Is, Lyndsey Anthony, Anna E. Komistek, Philip C. Pritchett, Emma K. Swanson

SPARK Symposium Presentations

“Health is Where the Huddle Is”

Huddles are an evidence-based strategy to facilitate a culture of safety within nursing teams. A review of 158 huddle studies found that 44.3% reported improved clinical outcomes and 24.3% showed fewer medical errors when huddles were implemented (Pimentel et al., 2021). Currently, a local hospital’s 13-bed ICU lacks an effective system for nursing staff to huddle due to staffing constraints and the absence of monitor technicians, creating safety concerns when nurses leave monitors unattended. This project aims to implement an effective, nurse-led shift huddle that maintains continuous patient monitoring while also strengthening patient safety …

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 …

Ai And Algorithmic Literacy Among Health Workers: A Scoping Review Through A Digital Health Literacy Lens, Ihoghosa Iyamu, Carly Wheelans, Devon Haag, Ian Roe, Hsiu Ju Chang, Lorie Donelle Phd, Rn, Fcan, Faan, Ursula Ellis, Geoffrey Mckee, Sofia Bartlett, Mark Gilbert

Publications

Introduction – Artificial intelligence (AI) and algorithmic systems influence health workers’ access, interpretation, and action on clinical and public health information, positioning them as intermediaries between algorithmically mediated outputs and patients, communities, and decision makers. This study examines how AI and algorithmic literacy are conceptualized and measured among health workers through a digital health literacy (DHL) lens. Methods – Using Arksey and O’Malley’s scoping review framework, we searched Ovid MEDLINE, Ovid Embase, Scopus, IEEE Xplore, ACM Digital Library, Europe PMC, and arXiv for English language sources published between January 2020 and May 2025. Two reviewers screened records and extracted data …

Staff Education To Nurses To Increase Nursing Staff Knowledge On Qsofa, Pamela Robert

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of a structured staff education program aimed at improving nurses’ knowledge and confidence in early sepsis recognition and management using the quick Sequential Organ Failure Assessment (qSOFA) tool. Despite the availability of evidence-based screening methods, inconsistent application and limited nurse confidence were identified as key practice gaps. Guided by the Johns Hopkins Evidence-Based Practice model and the ADDIE instructional design framework, an educational intervention was developed and delivered to hospital-based nurses, focusing on qSOFA criteria, early identification of sepsis, and nurse-driven escalation pathways aligned with current clinical guidelines. A pre- …