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Exploring The Motivations And Educational Needs For Undergraduate Nursing Students To Enter Into Critical Care: A Qualitative Study., Christina S. Pradhan

Doctoral Dissertations and Projects

Critical care nursing is a specialty that demands a high level of skill and dedication. In this high-stress, fast-paced environment, nurses must think fast and act decisively with sound clinical judgment and knowledge. The purpose of this hermeneutic phenomenological qualitative study was to understand the motivating factors that cause nurses to enter the field of critical care, as well as to explore the ways in which undergraduate nursing studies may be improved to better prepare future critical care nurses. Knowles’ adult learning theory was well suited for nursing students bound for a critical care path. Students at two different baccalaureate …

Understanding The Experience Of Separation On The Substance-Exposed Mother-Infant Dyad, Tamara Lee Depascale

Electronic Theses and Dissertations 2020 - Present

Maternal-infant separation following birth is a profoundly distressing experience that may have significant emotional, relational, and health implications for mothers with substance use disorders (SUD). Guided by Caring Science and Swanson’s Theory of Caring, the purpose of this qualitative descriptive study was to explore the dimensions of the health challenge associated with maternal-infant separation among mothers with SUD following birth and the approaches mothers used to navigate and respond to that experience. Data were collected through semi structured interviews with mothers who had experienced separation from their infants following birth and analyzed using deductive and inductive thematic analysis. Findings revealed …

Exploring Nursing Students' Experiences Of Simulation-Based Learning In Developing Critical Thinking, Clinical Reasoning And Clinical Judgment In The Management Of Mental Health Patients: A Qualitative Case Study, Irene Bellew

Doctoral Dissertations and Projects

The purpose of this case study was to explore how simulation-based learning experiences shape the development of critical thinking, clinical reasoning, and clinical judgment for associate degree nursing students when caring for patients with mental health needs. It addressed the need to narrow the gap between theoretical knowledge and practical application in clinical settings, enhancing the preparedness of novice nurses. By positioning nurse educators as facilitators of innovative strategies, this study advocates for the integration of simulation-based learning within nursing curricula. Roy’s adaptation model guided the study, and data were collected through observation of simulation sessions, semi-structured interviews, and reflective …

Uncovering The Path To Diagnosis Among Adults With Attention-Deficit/Hyperactivity Disorder: A Constructivist Grounded Theory Mini-Study, Jeffrey D. Whitaker, Rick Zoucha, Melissa Kalarchian

Graduate Student Research Symposium

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical …

Continuous 1:1 Sitter Observation Versus Standard Safety Interventions To Reduce Falls In Hospitalized Adults At Risk, Zainab Williams

Student Scholarly Projects

Practice Problem: Patient falls remain a significant patient safety concern among hospitalized adults, particularly those at high risk. Traditional fall-prevention strategies, including continuous 1:1 sitter observation, require evaluation to determine their effectiveness in reducing falls and fall-related injuries.

PICOT: In hospitalized adult patients at high risk for falls (P), does continuous 1:1 sitter observation (I), compared to standard safety interventions (C), reduce fall rates (O) as measured by reported falls per 1,000 patient days during hospitalization over 12 weeks (T)?

Evidence: Current evidence supports multifactorial fall-prevention programs that combine patient assessment, staff engagement, and proactive nursing interventions through intentional rounding. …

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

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 …

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 …

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 …

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. …

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, …

Reducing Missed Opportunities For Crc Screening Via Provider Reminder System In A Primary Care Setting, Komfort Cofield

Doctor of Nursing Practice Projects

Background: Although highly preventable with screening, colorectal cancer (CRC) continues to be a major source of illness and mortality in the United States. Healthcare providers at the Doctor of Nursing Practice (DNP) project site inconsistently ordered CRC screening for eligible patients due to deficiencies in the point-of-care reminder system. These system failures created missed opportunities for CRC prevention and reduced compliance with established practice guidelines.

Purpose: This DNP project aimed to implement and evaluate a CRC screening checklist given to patients at appointment check-in, serving as a reminder for providers to order appropriate screening tests.

Project Design: Using the National …

Addressing Hypertension Medication Non-Adherence Through The Use Of Reminders And Morisky Medication Adherence Scale In Adults Diagnosed Within The Past Year In A Rural Primary Care Clinic, Amanda M. Weaver

Doctor of Nursing Practice Projects

Background: Adherence to antihypertensive medications is essential for decreasing long-term consequences of uncontrolled hypertension, including stroke, kidney failure, and cardiovascular diseases. However, nonadherence is a widespread problem among patients diagnosed with hypertension. In patients who have been diagnosed with hypertension in the past year, more than half stop taking their medications. Mobile health interventions, such as text message or telephone reminders, are a low-cost way to improve medication adherence.

Purpose: The purpose of this Doctor of Nursing Practice project is to examine how a weekly text message or telephone reminder impacts medication adherence among patients taking antihypertensives in a rural …

Reducing Asthma-Associated Absenteeism At A School-Based Health Center Using Asthma Control Test (Act) Scoring, Concetta Terry

Doctor of Nursing Practice Projects

Background: Asthma is a common chronic condition that can lead to increased school absences and lower academic performance. A needs assessment at a rural school-based health clinic identified gaps in care for students with asthma and high absenteeism rates.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce asthma-related absences by personalizing care using Asthma Control Test (ACT) scoring.

Project Design: Using a pre- and post-intervention design, this DNP quality improvement project followed the Plan-Do-Study-Act (PDSA) framework to evaluate the impact of implementing the ACT on asthma-related absenteeism in a rural school-based health center. The project …

Reducing Missed Appointments In An Ambulatory Infusion Center, Jacqueline G. Jones

Doctor of Nursing Practice Projects

Background: Missed appointments at ambulatory infusion centers (AIC) continue to be a problem, even with improved scheduling systems and care coordination efforts. Nationally, missed appointment rates average 10%–12%, and in Central Alabama, the rate is 11.7%. However, one local AIC has a much higher missed-appointment rate of 17.8%. Missed appointments lead to wasted facility resources, increased healthcare costs, and interruptions in infusion therapies.

Purpose: This Doctor of Nursing Practice project used live reminder calls to help lower missed appointments in an AIC. The goal was to improve attendance, reduce missed appointments, and maintain consistent care.

Project Design: Over ten weeks, …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

Optimizing Daily Central Line Review: A High-Reliability Qi Project, Heather Khan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Prolonged central line use increases the risk of infection. At baseline, central line utilization in a 21-bed medical intensive care unit exceeded organizational goals and the national median. Gaps in the central line review process and variation in staff knowledge contributed to overutilization.

 Aim of the Project: The project team aimed to improve patient outcomes by reducing the central line standardized utilization ratio (SUR) from 0.93 to the national median of 0.79 over 12 weeks.

Review of the Evidence: Evidence supports standardization, use of decision-support tools, measurement, and auditing to reduce central line utilization. Leadership engagement, safety culture, and …

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 …

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

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 …

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …

The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady

Nursing

No abstract provided.

Correlation Between Overthinking And Procrastination Behavior Among Nurses, Mona Hassan Abdelaal

Nursing

ABSTRACT Context: A key challenge in understanding internalizing psychological disorders is identifying the cognitive processes that sustain distress and disrupt effective functioning. Recurrent, hard-to-interrupt thinking patterns may interfere with individuals’ ability to initiate and complete intended tasks. Concurrently, individuals may persistently delay necessary actions despite recognizing their negative consequences, indicating a breakdown between intention and behavior. This pattern of delay appears to be associated with seeking short term emotional relief, reduced consideration of future outcomes, and avoidance of prolonged effort. While these issues have been studied independently, their overlapping mechanisms require further investigation. The potential role of repetitive cognitive processes …

Co-Design And Pilot Testing Of A Nurse-Led Gp-Supported Self-Management Intervention For Breast Cancer Survivors With Cardiovascular Diseases: A Study Protocol, Anu Correya, Jing Yu Tan, Xian Liang Liu, Daniel Bressington, Leah East, Tao Wang

Research outputs 2022 to 2026

Background/Objectives: Self-management intervention strategies are recommended to address the needs of breast cancer survivors (BCSs) who have cardiovascular diseases (CVDs). Despite the benefits, these strategies are often suboptimally implemented, resulting in inadequate cardiovascular management among BCS with CVDs. The project aims to develop a nurse-led and GP-supported self-management (NGPS) intervention to reduce cardiovascular risks in BCS with CVDs and evaluate its feasibility and potential effects in primary care settings using the double diamond co-design process and the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions.

Methods: The study will be conducted in two phases. In phase I, …

Cleft Lip And Palate: From Genetic Foundations To Psychological Impact – A Multidisciplinary Review, Farah Abdulwahab Al-Saadi, Teeba Fares Hadi, Sura Saleem Albermani

Al-Esraa University College Journal for Medical Sciences

Cleft lip and/or cleft palate consider one of the most known and common congenital disorders of the head causing clear disruption of the normal face structure. Despite being the most seen birth defects, the clefts genetic basis is still not fully comprehended. Clefts have sporadic genetic nature, it can occur duo to rare mutations as part of syndromic disease or it can be isolated, non-syndromic cleft. The contemporary advances in genomic technology have enabled a deeper comprehension of the complex architecture of cleft lip/palate, of these technologies are genome-wide association studies, whole genome sequencing, transcriptome-wide association studies and others. Furthermore, …

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

Al-Esraa University College Journal for Medical Sciences

No abstract provided.

Reinforcement Of Maxillofacial Silicone, Taqwa Majid Abdulhussein, Thekra Ismael Hamad

Al-Esraa University College Journal for Medical Sciences

Maxillofacial prostheses are very important for helping people with head and neck defects (caused by congenital disabilities, accidents, or cancer treatments) get better. Their goal is to restore oral function, comfort, appearance, and mental health. Since the 1960s, silicone elastomers, especially polydimethylsiloxane, have been considered the best materials because they are highly resistant to tearing and stretching, biocompatible, and naturally colour-stable, but silicone has a very short clinical lifespan because it breaks down when exposed to UV radiation, moisture, biological fluids, and mechanical stress. The main goal of reinforcement is to add fillers to silicone elastomers to strengthen and improve …

Associated Factors Of Quality Of Life In Hypertensive Patients: A Cross-Sectional Study In Riau Province, Indonesia, Dhimas Maybelliano, Rajunitrigo Rajunitrigo, Lita Lita, Abdurrahman Hamid, T Abdur Rasyid

Jurnal Epidemiologi Kesehatan Indonesia

Hypertension is a chronic condition that adversely affects quality of life (QoL). Identifying factors associated with QoL is essential for improving hypertension management. This study aimed to identify factors associated with QoL among hypertensive patients in Riau Province, Indonesia. A cross-sectional study was conducted from December 2024 to January 2025 at two public health centers in Riau Province: Puskesmas Rejosari in Pekanbaru City and Puskesmas Bagansiapi-api in Rokan Hilir Regency. A total of 150 hypertensive patients aged 25-59 years were enrolled. QoL was assessed using the WHOQOL-BREF questionnaire. Independent variables included sociodemographic characteristics, comorbidities, dietary patterns, and physical activity. Data …