Digital Commons Network^™

Implementation Of Quantitative Blood Loss To Detect Postpartum Hemorrhage After Vaginal Birth, Raven S. Simpson

Dissertations

Problem: In the U.S., postpartum hemorrhage (PPH) is attributed to maternal morbidity and mortality, resulting in long-lasting effects of extended recoveries, surgical interventions, birth-related trauma, interruptions in mother-infant bonding, or death. Performing estimated blood loss (EBL) measurement methods postpartum is subjective and often associated with over- and underestimations of blood volume. The delay in recognition interferes with timely, efficient, and appropriate interventions, yielding a PPH (≥1000ml).

Methods: A quality improvement (QI) project was initiated with a descriptive, pre-implementation/post-implementation focus on a high-risk Labor and Delivery unit to explore the effects of Quantitative Blood Loss (QBL) measurements on the identification of …

Implementation Of A Human Papillomavirus Vaccination Toolkit Postpartum, Emily R. Leone

Dissertations

Problem: Human papillomavirus (HPV) is the most common sexually acquired infection in the world (DeCherney et al., 2018). Even a single dose of the HPV vaccine can provide up to 97% protection against HPV 16 and 18, which are the strains that cause 70% of all cervical cancers (Barnabas et al., 2022). Missouri ranks 35th in the country for HPV vaccination (Office of Disease Prevention and Health Promotion, 2020).

Methods: This quality improvement project implemented an HPV toolkit consisting of: 1) staff nurse education in the form of a written presentation 2) patient and provider education in the form of …

Motivational Interviewing For Weight Loss: A Review Of Evidence-Based Outcomes In Overweight And Obese Adults, Marian Dover

Dissertations

Obesity is a significant clinical problem affecting 41.9% of adults in the United States, with profound implications for individual health and healthcare economics. Standard weight loss interventions, often limited to pharmacological treatments and dietary guidance, frequently fail to achieve sustained adherence and meaningful longterm outcomes. This quality improvement (QI) project evaluated the integration of motivational interviewing (MI), a patient-centered counseling strategy, into routine clinical practice at Innovafusion, a medically supervised weight loss clinic in Aubrey, Texas. The aim was to enhance adherence to lifestyle modifications, promote intrinsic motivation, and improve weight loss outcomes among adults aged 18–65. Using a retrospective …

Implementation Of Mindfulness-Based Interventions And Weekly Visits To Reduce Loneliness In Older Adults, Victoria E. Cobb

Dissertations

Implementation of Mindfulness-Based Interventions and Weekly Visits to Reduce Loneliness in Older Adults

Abstract:

Problem: Social isolation and loneliness have emerged as a significant public health issue for the older adult population. Loneliness has been linked to both physical and mental health effects. According to current literature, there is no standard intervention to treat loneliness in the older adult population.

Methods: This quality improvement (QI) project utilized a descriptive cohort design and the Visit-A-Bit screening assessment instrument. Undergraduate nursing students implemented mindfulness interventions during weekly visits over an eight-week period at an independent living facility located in the Midwest. Descriptive …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Race-Neutral Pft: Implementing Patient Activation Measure Following Race- Neutral Pulmonary Function Testing, Ann M. Way

Dissertations

Abstract

Background

The introduction of a race-neutral equation to predict normal values on pulmonary function testing (PFT) has led to changes in the diagnosis of pulmonary diseases previously diagnosed using a race specific equation. Minority patients appear to be most likely impacted by this change, potentially impacting how they self-manage their pulmonary health. Patient self-management can be measured and assessed by using the Patient Activation Measure (PAM) tool.

Purpose

The purpose of this project is to assess patient activation levels amongst minority patients with a new or changed pulmonary diagnosis to identify a possible need for interventions to improve patient …

The Psychological Impact Of Parenting Child Victims Of Trauma, Stephanie Faulkingham

Dissertations

Abstract

Research indicates that non-offending caregivers of traumatized children (NOC) is a population with an elevated risk for increased levels of depression and anxiety and are an underserved population for mental health services. The purpose of this quality improvement project was to determine if screening caregivers of traumatized children using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder (GAD-7) improves identification of depression and anxiety. Participants of this investigation were individuals enrolled in the Children’s Advocacy Services of Greater St. Louis’ 12-week parenting group, TASK (Trauma, Assessment, Skills, and Knowledge). Each participant was asked to complete the PHQ-8 and …

Depression Screening In The Adult Inpatient Oncology Population, Erica Bizub

Dissertations

Routinely screening oncology patients for depression is recommended due to the higher rates of depression in this population as well as the negative impact of untreated depression. The goal of this QI project is to implement a standard depression screening protocol for patients admitted to this hospital, where there is currently no standard screening protocol. There were 110 patients included in this study, and 67 (60.91%) of patients received a PHQ-9 screening. Of the patients who completed the PHQ-9, 21 (19.09%) had a positive screening, which was a score of seven or higher. While there were high rates of provider …

Screen Foundations: How Pediatric Nurse Practitioners Can Implement ‘Family Media Use Plans’ In Primary Care To Reduce Pediatric Behavior Concerns, Katie Anderson

Dissertations

Abstract for:

Screen Foundations: How Pediatric Nurse Practitioners Can Implement ‘Family Media Use Plans’ in Primary Care to Reduce Pediatric Behavior Concerns

Problem: Parents of children 2-5 years-old increasingly reach out to PCPs for escalating behavior concerns, including when the child doesn’t listen well, is inattentive, having tantrums, meltdowns, hitting, yelling, etc. Referrals to psychiatry and/or play therapy result in long waits, or referrals not accepted. Coincidingly, toddler and preschool aged children continue to exceed daily screen time recommendations. This results in a gap of care for families with young children and externalizing behavior.

Methods: This quality improvement project addressed …

Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo

Student Scholarly Projects

Practice Problem: Burnout Syndrome (BS) is a serious problem in emergency department (ED) nurses and is associated with higher nurse turnover rates. A burnout prevention toolkit is needed.

PICOT: The project was guided by the following PICO question: "For emergency department nurses (P), how does the development of the best practice burnout prevention toolkit (I), compared to the absence of a structured intervention (C), support the establishment of nurse burnout best practices when evaluated using the CDC Program Evaluation Framework? (O)".

Evidence: The analysis of the literature supported the implementation of active interventions in the form of workshops.

Intervention: A …

Quality Improvement Project Educating Nursing Faculty On The Lasater Clinical Judgment Rubric In Simulation, Tiffany Shivers

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance nursing faculty preparedness in simulation-based education by increasing knowledge and self-efficacy using the Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental, one-group pre-/post-intervention design was used to evaluate outcomes among ten faculty participants. The intervention consisted of an educational session introducing the LCJR and structured debriefing techniques. Data were collected using a knowledge assessment and the General Self-Efficacy Scale. Descriptive statistics and the Wilcoxon Signed-Rank Test were used to analyze changes in scores. Results demonstrated statistically significant improvements in both knowledge (Z = –2.805, p = .005) and self-efficacy (Z = –2.666, p = …

Impact Of Primary Care Healthcare Providers Patient Electronic Medical Records Completion Rates Using Speech Recognition Dictation, Pepper Losely

Student Scholarly Projects

Practice Problem: Completion of electronic medical records (EMRs) is an ongoing problem for providers, facilities, and insurance reimbursement. Current completion of EMRs lack standardized processes to make EMRs completion easier for providers with their busy workday and allow optimal time for patient care.

PICOT: For healthcare providers at primary clinics (P) will implementing speech recognition dictation (SRD) for data entry into the electronic medical records (EMRs) (I) compared to the current practice of manually typing all data causing long medical record turnaround times (c) improve medical record completion within 30 days (O) over 10-weeks (T).

Evidence: Evidence that was …

Cultural Humility, Holistic Admission Review, And Multicultural Experiences Among Newly Admitted Nursing Students, Janna Michelle Hackett

Nursing ETDs

This study explored the impact of Holistic Admissions Review (HAR) on demographic characteristics, multicultural experiences, and cultural humility (CH) levels among newly admitted pre-licensure nursing students. Fostering CH and diversity among healthcare providers may help reduce health disparities. Traditional admissions methods may not identify candidates with traits supporting CH development, whereas HAR considers diverse backgrounds and experiences. Two groups were surveyed: one admitted through HAR and the other through traditional methods. No significant differences in CH scores were found, but significant differences were found in age, living abroad, and volunteering with diverse populations. Students admitted through HAR were younger and …

The Healthcare Workforce In Nevada, 2024, Olivia K. Cheche, William E. Brown Jr., Caitlin J. Saladino

Health

This fact sheet presents data on the healthcare workforce in Nevada. The U.S. Bureau of Labor Statistics’ Occupational Employment and Wage Statistics Query System provides data on the amount of employment in all job sectors at the state and metropolitan statistical area (MSA) levels. This fact sheet focuses on employment and wage data for the State of Nevada, the Las Vegas-Henderson-Paradise, NV MSA, and the Reno, NV MSA as of May 2024.

Impact Of A Mentorship Program On School Nurse Confidence, Shanna Groom

Doctor of Nursing Practice Projects

The prevalence of chronic health conditions in children has risen in recent years. As a result, school nurses are now expected to manage medically fragile students while also responding to acute and emergent health issues. This increasing complexity adds extra demands to school nurses, emphasizing the need for strong clinical decision-making skills and confidence. Mentorship programs have been proven to increase the confidence of nurses and are a core essential of the national standards and framework for school nurses. The problems addressed by this project were the lack of a mentorship program in a large school district for newly hired …

Speak Now With The Courage To Confront: An Educational Intervention To Address Bullying, Dominique Desiree Gomez

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Nurse-to-nurse bullying is a critical issue within the nursing profession, impacting close to half of all nurses. This phenomenon, articulated by the phrase "nurses eat their young," detrimentally influences employee retention, job satisfaction, morale, and ultimately, patient care. Furthermore, nurse-to-nurse bullying significantly affects the well-being of nursing professionals, particularly targeting novice nurses. This targeting raises substantial concerns regarding their retention, as many consider leaving the profession within their initial years of practice due to experiences of bullying. The educational intervention project titled “Speak Now with the Courage to Confront” is designed to mitigate bullying among novice nurses through …

Staff Education Project: Staff Education To Improve Nurses’ Knowledge, Self-Efficacy, And Motivation In Supporting Medication Adherence, Giovanna Happy

Walden Dissertations and Doctoral Studies

Medication nonadherence among individuals with psychiatric disorders remains a significant barrier to recovery, ranging from 40% to 60%. Contributing factors include fear of side effects, stigma, cognitive limitations, and complex regimens. This staff education project addressed challenges through the implementation of a structured, evidence-based intervention to improve adherence-supportive practices among 14 outpatient psychiatric nurses. A preimplementation needs assessment revealed inconsistent application of adherence strategies and low staff confidence. The project’s objective was to evaluate whether a structured education program could improve nurses’ knowledge by 15%, confidence by 15%, and willingness by 3.5 points on a Likert scale to promote medication …

Staff Education Project An Educational Project To Educating Mental Health Staffs On Stress Management To Improve Knowledge And Staff Retention, Lilian Eneude

Walden Dissertations and Doctoral Studies

This evidence-based educational project addressed the knowledge gap in stress management techniques among mental health nursing staff at an acute psychiatric facility. Mental health professionals experience substantially higher rates of workplace stress and burnout compared to other healthcare workers, affecting staff wellbeing, patient care quality, and organizational outcomes. The practice-focused question was: Does educating mental health nurses on stress management improve knowledge as evidenced by pre- and post-intervention? A comprehensive literature search was done at the Walden University Library using CINAHL, PubMed, and PsycINFO databases that yielded 200 potential articles, with 45 full-text articles reviewed and 20 high-quality studies included …

A Student-Centered Coaching Program In Jesuit & Mercy Traditions, Sara Gifford, Karen Mihelich, Arthur Ko

Jesuit Higher Education: A Journal

A student-centered coaching program grounded in Jesuit and Mercy traditions, called “Coaching for Care,” was implemented at a midwestern Jesuit and Mercy institution. The purpose of the project was to evaluate the development of future nurse educators’ pedagogy, foster holistic licensure examination preparation among pre-licensure nursing students, and examine students’ perceptions towards the program’s guiding Jesuit and Mercy values. Pre-licensure students who received coaching felt that their uniqueness/holism, accountability, and reflection were important for their licensure exam preparation at significantly higher rates than pre-licensure students who did not receive coaching. Themes identified from the doctoral student coaches included instilling confidence …

What Is Midwifery Work In Low And Middle-Income Countries? A Systematic Review To Enhance Midwifery Practices In Resource-Constrained Contexts, Qorinah Estiningtyas Sakilah Adnani, Ela Nurfitriyani, S. Tr. Keb, Niken Bayu Argaheni, Rufidah Maulina, Victor Abiola Adepoju, Maeve O’Connell

Journal of Asian Midwives (JAM)

Background: Midwifery plays a crucial role in enhancing maternal and newborn health outcomes in low- and middle-income countries (LMIC). This systematic review aims to provide a comprehensive and evidence-based evaluation of midwifery practice in LMIC, beyond specific outcomes and interventions.
Methods: A systematic literature search was conducted using electronic databases including PubMed, Embassy, Scopus, Web of Science, and CINAHL, covering the period from 2019 to 2023. The search strategy employed predefined keywords and Medical Subject Headings (MeSH) terms related to midwives, maternal health, newborn health, and LMIC. The findings were analyzed using a narrative synthesis approach to identify key …

Improving Depression Screening Of Correctional Institution Inmates, Thelma Chidimma Ozigbu

Doctor of Nursing Practice Scholarly Projects

Problem: Depression significantly impacted on the quality of life of incarcerated individuals within correctional facilities, where rates of the disorder far exceed those in the broader community, increasing self-harm and suicide risks.

Purpose: This quality improvement project aimed to improve early identification of depressive symptoms and facilitate timely mental health referrals by implementing the Patient Health Questionnaire (PHQ-9) as a screening tool upon admission.

Method: Using the Iowa Model of Evidence-Based Practice (Iowa Model) as a guiding framework, this project involved training nursing staff to administer the PHQ-9 during initial health assessments. PHQ-9 is a nine-item questionnaire that assesses depression …

Enhancing Glycemic Control, Patient Knowledge, And Self-Care Through Structured Diabetes Education, Amanda Suzanne Clark

Doctor of Nursing Practice Scholarly Projects

The rising prevalence of diabetes, particularly in South Carolina, revealed a significant gap in structured diabetes education programs, contributing to poor glycemic control and elevated A1C levels. In response, this project aimed to assess the integration of a comprehensive diabetes education program into standard care, potentially reducing A1C levels while improving patient knowledge and self-care behaviors in adults with diabetes over four months. The study used a pretest-posttest design to evaluate the effectiveness of this innovative intervention by comparing participants' outcomes before and after the program. Purpose: To determine if a comprehensive diabetes education program could reduce Hemoglobin A1C levels …

Exploring Veteran And Non-Veteran Nursing Student Satisfaction Utilizing Marginality And Financial Stress, Juanita Nickols

Nursing Theses and Dissertations

It is widely recognized that there is a nursing shortage in the U.S. due to a growing aging population, nurses retiring, and a low nursing school capacity. Nursing schools can ameliorate part of this shortage by devising ways to increase nursing student success and graduation rates. This three-manuscript paper aims to present various ideas to help nursing schools in this endeavor. A relatively unstudied population is the veteran nursing student (VNS), the focus of this paper. The first chapter, Chapter 2: A Concept Analysis of Overload: Implications for Undergraduate Nursing Students Success, discusses the concept of overload so the …

Decreasing Burdensome Transitions In Hospice Care By Increasing Nursing Visits, Kristin S. Rivers

Doctor of Nursing Practice Projects

Background: Burdensome transitions occur when hospice patients discontinue hospice services to seek hospital treatment, often disrupting end-of-life goals and creating distress for patients and caregivers. These transitions continue to rise throughout the country, highlighting the need for strategies to support patients in remaining at home throughout the dying process.

Purpose: This quality improvement project aimed to decrease hospital transitions by increasing nursing visits for hospice patients at high-risk for burdensome transitions.

Project Design: This quality improvement project used a Plan-Do-Study-Act methodology to form and implement an intervention to reduce burdensome transitions. Patients were already identified as low or high-risk …

An Exploration Of The Effect Of Covid Restrictions On Maternity Care In Uganda, Hellen Kyakuwaire, Grace Edwards, Ahmed Mohammed Sarki

Journal of Asian Midwives (JAM)

Background: Uganda responded aggressively to the worldwide spread of COVID-19 by imposing a total lockdown, which forbade movement of the whole population, including pregnant women and other vulnerable groups. This phenomenological study explored pregnant women’s experiences during the total lockdown in Uganda and identified factors that influenced the quality of healthcare for pregnant women during the lockdown.
Methods: Thirty-two newly delivered women were selected across a wide geographical area to represent rural and urban areas. The sample was selected from women who had given birth at the selected health facilities from March 18, 2020, to April 30, 2020. …

The Effects Of Midwifery Students’ Simulation Training In Perineal Repair: A Quasi-Experimental Study, Zahra Sadat Pajohideh, Solmaz Mohammadi, Fatemeh Keshmiri, Azam Honarmandpour, Azam Jahangirimehr

Journal of Asian Midwives (JAM)

Background: The decrease in normal deliveries and episiotomies in midwifery practice has reduced the experience of midwifery students in perineum repair. This study examined the effect of perineal repair simulation training on the clinical skills of midwifery students by designing, implementing and evaluating simulation models in procedural education.
Methods and materials: This quasi-experimental study was conducted on 60 midwifery students in intervention and control groups at Shoushtar, Iran, from September 2018 to August 2021. The intervention group received simulation training before entering the formal clinical education courses, while the control group took part in workplace-based training. The clinical repair skills …

The Impact Of The Covid-19 Pandemic On Maternity Care Services: Lived Experiences Of Midwives In Indonesia, Mergy Gayatri, Oluwadamilare Akingbade, Indhar Wahyu Wira Harjo, Adepegba Folasade Rebecca, Salako Faith Adebola

Journal of Asian Midwives (JAM)

Background: There have been fundamental changes in global maternity care in response to the COVID-19 pandemic across the globe. However, there are limited studies in Indonesia that have explored the changes experienced by midwives in various health facilities during the COVID-19 pandemic.
Method: A qualitative phenomenological study was conducted among midwives with at least three years of clinical experience in midwifery practice and practicing at different levels of healthcare. Semi-structured interviews were conducted through WhatsApp or Phone calls, as face-to-face interviews were impossible during the pandemic. Data were analyzed using thematic analysis.
Results: In total, 24 midwives …

The Relationship Between Sleep Quality And Physical Fitness Toward The Menstrual Cycle In High School Students, Surya Adi Saputra, Raja Mohammed Firhan Bin Raja Azidin, Alifia Candra Puriastuti, Dessy Amelia, Zumroh Hasanah, Anggi Renawati

Journal of Asian Midwives (JAM)

Background: Sleep is essential for maintaining physical fitness and overall health, as it helps the body recover from intense physical activity and maintains endurance. Physical fitness is determined by heredity, gender, age, body composition, activity, and exercise. Adequate sleep positively impacts overall health, while poorer sleep can negatively affect the body. Teenagers often prefer excessive screen time and oversleep, which can affect their sleep quality. Physical fitness is related to physical activity, and the more often an individual engages in physical activities, the better their fitness. This condition can also impact reproductive health, as hormonal disorders can affect the menstrual …

Perceptions Of Risky Sexual Behavior Among Female Students: A Qualitative Analysis Of Contributing Factors, Consequences, And Prevention Strategies, Leila Bozorgian, Fatemeh Ansari, Fatemeh Janipour, Solmaz Mohammadi

Journal of Asian Midwives (JAM)

Background: Risky behaviors among young people are a significant concern for societies worldwide, leading to physical and psychosocial damage. Despite efforts to raise awareness about such risky behaviors over the past two decades, their prevalence continues to rise. Therefore, this study aimed to explain perceptions of the prevalence of risky sexual behaviors among female students.
Methods: A qualitative descriptive study using a conventional content analysis approach was conducted from August to mid-September 2024 in Yasoj, Iran. The study participants were selected using purposive sampling. The data were collected using semi-structured interviews conducted with 18 female students. Data collection …

Development And Validation Of Risk Assessment Tools For Hypertensive Disorder In Pregnancy, Vanitha K, Hepsibah Sharmil, Vijayalakshmi Kandasamy

Journal of Asian Midwives (JAM)

Aims and Background: Hypertensive disorders in pregnancy (HDP) have significant impact on both mothers and newborns leading to complications such as Eclampsia, Preterm delivery, Renal and cardiac problems, Intra Uterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Early screening of hypertensive disorders in pregnancy is essential in the prevention and management of these complications. This research study aims to develop and validate a risk assessment tool for hypertensive disorders in pregnancy.
Materials and methods: A mixed-method research was carried out from December 2023 to December 2024 consisting of two steps. Step one involved the development of …