Riddle Me Resilient: Investigating The Impact Of Riddle Based Class Openings On Student Resilience And Well-Being, Carolyn T. Brown

DNP Projects

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Abstract

Background: Burnout among nurses and nursing students is a widespread and well‑documented problem that adversely affects professional performance and psychological well‑being. Resilience serves as a key protective factor, helping buffer the effects of academic stress and reducing burnout over time. Incorporating brief, low‑stakes cognitive challenges—such as a riddle—can help foster resilience.

Purpose: This project evaluated the impact of incorporating riddles into a wellness-focused course, Introduction to Mindfulness and Wellness, on resilience and well-being among undergraduate nursing students.

Methods: This project employed an Institutional Review Board approved pre-post survey design to measure the effect of an intervention focused on …

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Building Confidence And Team Communication: Implementation Of A Rapid Response In Situ Simulation Program In The Neonatal Intensive Care Unit, Janell F. Hacker

DNP Projects

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Background: Neonatal code events are high-risk, low-frequency occurrences in the neonatal intensive care unit (NICU). Simulation-based training is used to support skill development, maintain competencies, and enhance team performance.

Purpose: The purpose was to determine if a multidisciplinary, high-fidelity, rapid response in situ simulation program would impact confidence and communication among frontline healthcare providers during neonatal code events.

Methods: A quasi-experimental, pretest-posttest study was conducted in a 90-bed Level IV NICU. A multidisciplinary, high-fidelity in situ rapid response simulation program was implemented over a 3-month period for frontline NICU healthcare providers. Pre- and post-surveys assessed perceptions of role clarity, …

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Factors Influencing Senior Practicum Readiness For Nursing Practice: A Descriptive Correlational Study, Beth Nease Phd, Dnp, Rn, Ne-Bc, Cynthia F. Corbett Phd, Rn, Faan, Stephanie Armstrong Phd, Msn, Rn, Kesheng Wang Phd, Ma, Bs, Kathy Casey, Kong Chen

Faculty Publications

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Background:

This study investigated the influence of belongingness, self-efficacy, and clinical learning support on readiness for nursing practice and explored the role of demographic factors and nursing program differences.

Method:

A quantitative, descriptive approach was used to explore undergraduate prelicensure senior nursing students' perceptions across the United States.

Results:

Descriptive statistics, Pearson correlation, and multiple linear regression demonstrated students in traditional Bachelor of Science in Nursing programs reported significantly higher scores across all domains compared with those in associate degree programs (p < .01). Similarly, students in programs with ≤400 clinical hours and those assigned only one preceptor scored significantly higher on all measures (p < .01 and p < .05, respectively). Regression analysis indicated self-efficacy and learning support explained 47.9% of the variance in practice readiness (p < .05).

Conclusion:

These findings share how clinical experiences shape students' readiness for nursing practice. Recommendations …

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Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

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This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

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Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

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Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

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Treatment Manual For Nonsequential Format. Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course)., Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

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This is the Treatment Manual for NonSequential Format: Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

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Building Self-Perceived Confidence Through Occupational Therapy And Nursing Student Peer Teaching, Jennifer A. Tokash, Melissa Nolan, Jamie Bittiger, Jessica Wagoner, John Damiao, Michelle Lopez

Journal of Occupational Therapy Education

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Peer teaching, which is student-to-student instruction, has emerged as a promising pedagogical strategy in higher education, yet it remains underexplored in health professions curricula. While traditional professor-led instruction remains the predominant model, peer teaching may offer comparable or enhanced outcomes, particularly in fostering students’ self-perceived confidence and active learning. This study examined the impact of peer teaching on nursing students’ self-perceived confidence in applying ergonomic principles and performing safe patient handling techniques, as instructed by occupational therapy students. Additionally, the study assessed occupational therapy students’ self-perceived confidence in measuring vital signs following instruction provided by nursing students. Using a quasi-experimental …

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Opioid Abuse: Community Education, Meggan N. Wolff-Jackson

Doctor of Nursing Practice Projects

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The opioid epidemic in the United States has persisted for over two decades and has become one of the leading causes of accidental deaths nationwide (Robert et al., 2022). The opioid crisis represents a widespread public health emergency that extends beyond individual and community boundaries, imposing burdens on both the national economy and the healthcare system (Kyei et al., 2024). Although the opioid epidemic is a global concern, it is particularly concerning in the target community located in the western part of North Carolina. This region has some of the highest rates of opioid overdoses within the state, with 118 …

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Integrating Lactation Education Into Centering Pregnancy To Enhance Maternal Confidence And Lactation Initiation Rates, Courtney Barbee

Doctor of Nursing Practice Projects

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Introduction: Breastfeeding remains the gold standard for infant nutrition providing physical and psychological benefits for both mother and baby. The inadequacy of lactation education and support continue to hinder breastfeeding initiation in the rural areas of North Carolina. Integrating a board-certified lactation consultant into the Centering Pregnancy model provides an evidence-based strategy to improve maternal confidence and increase lactation initiation rates within the target community.

Method: Using a quality improvement framework, the project targeted expecting mothers participating in Centering Pregnancy. Pre- and post-surveys assessed confidence levels after receiving two educational sessions with a board-certified lactation consultant.

Results: …

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Building Clinical Competency In Central Line Care: A Nurse-Focused Initiative To Prevent Clabsis, Glenda A. Robbins

Doctor of Nursing Practice Projects

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Central line-associated bloodstream infections (CLABSIs) are a significant yet preventable source of increased morbidity, mortality, and healthcare costs in acute care settings. Despite established evidence-based prevention bundles, inconsistent nursing adherence remains a primary contributor to elevated CLABSI rates. A 241-bed acute care hospital reported CLABSI rates above the national benchmark. This Doctor of Nursing Practice (DNP) project utilized Neuman’s Systems Model. The intervention consisted of a structured educational module on central line care and maintenance, including pre- and post- knowledge assessments. Additionally, standardized daily central line visual audits were reinforced by the Vascular Access Team. A total of 363 bedside …

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Musical Measures: Nurse Education On Music-Based Interventions To Reduce Patient Restraints, Crystal D. Tucker

Doctor of Nursing Practice Projects

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The use of physical restraints in acute psychiatric settings poses significant risks to patient safety, including physical injury and psychological distress. Evidence supports the need for alternative, non-pharmacologic interventions to reduce reliance on restraints. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of an educational intervention on nurses’ knowledge and confidence in implementing music-based interventions, specifically binaural beats, to manage patient anxiety and agitation.

The project was conducted on a medical observation and behavioral health holding unit and utilized a pre- and post-intervention design. Registered nurses participated in educational sessions on music-based interventions and were …

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Increasing Awareness Of Obesity And Its Associated Risks In Adults, Esther E. Bayode

Doctor of Nursing Practice Projects

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Obesity is a significant and growing public health concern in a metropolitan area of North Carolina, reflecting statewide and national trends. With 36% of adults in North Carolina classified as obese, the condition contributes to chronic diseases such as hypertension, diabetes, heart disease, and certain cancers. This project targeted adults aged 18 and older within a local faith-based community, where preliminary findings showed a strong association between elevated body mass and increased chronic disease burden. To address this issue, a two-session educational intervention was implemented in partnership with a religious organization to increase knowledge about obesity, its causes, associated risks, …

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Improving Overall Morale Of Nurses By Implementing A Serenity Room, Ruth B. Clarke-Johnson

Doctor of Nursing Practice Projects

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Nursing, while a highly respected profession grounded in research and scientific practice, continues to face persistent challenges related to staff retention and morale. Key contributors include burnout related to high workloads, challenging staffing ratios, lack of supportive leadership, and an aging workforce. Together, these factors hinder healthcare organizations’ ability to sustain a stable and experienced staff. The implementation of a serenity or relaxation room is supported by growing evidence highlighting its positive effects on nurse morale and stress reduction. A review by Mileski et al. (2022) found wellness spaces significantly reduced burnout, emotional exhaustion, and stress while improving resilience, job …

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Enhancing Patient Safety And Team Communication Via Standardized Unit Handoff Tools In Inpatient Rehabilitation, Julia Rae Before

Master's Theses and Capstones

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Abstract

Background: Interdisciplinary safety huddles in healthcare are used to facilitate staff communication, voice patient safety concerns and identify high acuity patients, as well as identify current unit issues that need resolution. Using characteristics of safety huddles, revising patient report sheets to include pertinent safety information often shared during huddles may lead to an increase in staff perception of communication as well as awareness to patient safety concerns. Within an in-patient rehabilitation hospital, anonymous staff reports indicated dissatisfaction with interprofessional communication and microsystem data revealed increased events of adverse patient outcomes and safety concerns. Baseline data indicated inconsistent patient handoff …

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A Patient-Centered Approach To Improving Patient And Family Education On Perioperative Processes To Reduce Anxiety: A Quality Improvement Initiative, Ashley Lauren Doherty

Master's Theses and Capstones

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Background: Perioperative anxiety is common among surgical patients and their family members. Anxiety may be increased by uncertainty and limited understanding of the surgical experience. Improving perioperative education may enhance understanding, reduce anxiety, and support a more patient and family centered surgical experience.

Local Problem: A Post-Anesthesia Care Unit (PACU) identified knowledge gaps in patient and family education about the perioperative process. The existing waiting room bulletin board was outdated and provided limited information. PACU nurses observed anxiety-related behaviors and confusion among patients and family members about the perioperative process. Patient satisfaction surveys routinely collected by the hospital also demonstrated …

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Improving Operating Room First-Case On-Time Starts And Reducing Turnover Times: A Quality Improvement Project, Ashley Cote

Master's Theses and Capstones

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Abstract

Background: Delays in first case on-time starts (FCOTS) contribute to decreased operating room (OR) efficiency, increased healthcare costs, workflow disruptions, and reduced staff and patient satisfaction. Evidence suggests that standardized workflows, improved communication, and Lean Six Sigma methodologies can improve perioperative efficiency and reduce delays.

Local Problem: Baseline data from a local OR microsystem demonstrated an FCOTS rate of 77%, below the organizational benchmark of 80%. Root cause analysis identified inconsistent preoperative workflows, communication gaps, and variable staff adherence to standardized processes as primary contributors to delayed first-case starts.

Methods: A quality improvement project utilizing the Define, Measure, Analyze, …

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Improving Effective Completion Of Catheter Care Using A Reminder System To Minimize Incidence Of Catheter-Associated Urinary Tract Infections: A Quality Improvement Project, Morgan K. Leonard

Master's Theses and Capstones

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BACKGROUND: CAUTI rates can be decreased by implementing a care cluster for RNs for CAUTI care into morning assessments and medication administration to ensure it is being done regularly with reminders through cards at the computers in patient rooms. LOCAL PROBLEM: The local problem in the microsystem were the catheter-associated urinary tract infection (CAUTI) rates at 1.199, while the national benchmark is 1.000 (Medicare, n.d.).

METHODS: Reminder cards were placed in patient rooms on the computers which are highly utilized by staY while providing patient care to serve as a reminder to complete catheter care in a high task burden …

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Improving Efficiency In The Intensive Care Unit Through Reduction Of Nurse Burnout: A Quality Improvement Initiative, Johanna Grace Koroma

Master's Theses and Capstones

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Abstract

Background: Intensive care unit (ICU) nursing is prone to high levels of burnout, which poses concern for staff wellbeing, patient safety, and microsystem strain (Kerlin et al., 2020). Educational interventions may serve as a means of increasing awareness on the issue and reducing the effects of burnout, through promotion of evidence-based management strategies.

Local Problem: One ICU microsystem identified several key contributing factors to nurse burnout, including staffing shortages, limited resources, competing responsibilities within the macrosystem, and insufficient organizational support (Zhang et al., 2025). Baseline survey data of the population observed a prevalence of 50% “high” burnout profiles among …

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A Quality Improvement Initiative: Implementing An Effective Massive Transfusion Protocol Cognitive Aid Tool Within An Operating Room & Post-Anesthesia Care Unit Setting, Jenna L. Farrell

Master's Theses and Capstones

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Abstract

Background: Massive Transfusion Protocol (MTP) activations are low-frequency, high-acuity events in the post-anesthesia care unit (PACU) setting.  These events necessitate the rapid formation of codes teams, interdisciplinary communication amongst unfamiliar providers, critical decision-making, high-volume rapid blood transfusions, and critical laboratory marker monitoring.

Local Problem: Due to the infrequent nature of hemorrhagic events in the PACU, nurses may have limited experience participating in these protocols at their institutions, resulting in potential for documentation errors from retrospective back charting, decreased confidence regarding blood product sequencing and laboratory draw timing, and increased cognitive workload overall.  This quality improvement (QI) project implemented …

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Improving Nurse Well-Being And Patient Safety Through A Structured Break Buddy System: A Quality Improvement Project, Elizabeth Harrington

Master's Theses and Capstones

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Abstract

Background: Nursing burnout has become an increasing concern due to heavy workloads, staffing shortages, and the inability of nurses to consistently take uninterrupted rest breaks during their shifts. Missed breaks contribute to fatigue, emotional exhaustion, decreased job satisfaction, and an increased risk of patient safety events. Evidence suggests that structured break interventions may improve opportunities for recovery during the workday.

Methods: A quality improvement (QI) project was conducted on a respiratory care unit at a midsized hospital in central New Hampshire using the Plan-Do-Study-Act (PDSA) framework. A microsystem assessment identified inconsistent break-taking as a significant gap. A five-question anonymous …

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Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

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Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

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Correlates Of Recovery Capital Among Women In Jails: Leveraging A Dimensional Recovery Framework, Amanda Fallin-Bennett, Martha Tillson, Jaxin Annett, Hartley Feld, Michele Staton

Nursing Faculty Publications

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Background: Recovery capital encompasses internal and external factors that support recovery from substance use disorder, such as employment, social support, and physical and mental health. There is a need for more research on recovery capital among women who are incarcerated, who often face complex barriers to recovery, such as poverty, unemployment, and histories of trauma.

Methods: Women (N ¼ 900) were recruited from Kentucky jails as part of the broader NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative project. Measures from baseline interviews (during incarceration) were selected in alignment with the Substance Abuse Mental Health Service Administration (SAMHSA)’s four …

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“Being Treated As The Expert:” A Blueprint For A Community Advisory Board Approach To Elevate The Voice Of People With Living Experience With Substance Use In Academic Research, Trevor Moffitt, Survivors Union Of The Bluegrass, Bryson Henson, April M. Young, Sharon L. Walsh, Rachel Vickers-Smith, Junior Cruz, Jeremy Byard, Brook West, Amanda Fallin-Bennett

Nursing Faculty Publications

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Introduction: Researchers have traditionally engaged Community Advisory Boards (CABs) to meaningfully involve community members in the research process. However, CABs are often formed only after a grant is funded, leading to criticisms of functioning merely as “ethical approvers.” For substance use researchers, the inclusion of people with living experience (PWLE; current experience with drug use) across all stages of research is especially important as they have historically been the experts in the needs of their community.   Methods: In response to this need for community engagement in research, the University of Kentucky, in partnership with a local recovery community center (RCC; …

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Evaluation Of A Tobacco Treatment Specialist Training Program Targeted To Behavioral Health Professionals, Chizimuzo T. C. Okoli, Sarret Seng, Bassema Abu Farsakh, Emily Koyagi, Heather Beck, Audrey Darville

Nursing Faculty Publications

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Tobacco use remains disproportionately high among adults living with mental illnesses (MIs), contributing to excess morbidity and mortality, particularly in high-burden states such as Kentucky. Behavioral healthcare providers are well-positioned to address this disparity but often lack formal training in evidence-based tobacco treatment. Tobacco Treatment Specialist (TTS) training provides healthcare providers with skills to deliver evidence-based tobacco treatment; however, traditional TTS training models often rely on synchronous, in-person or live virtual formats, which may limit accessibility for some healthcare workforces. Asynchronous, web-based delivery models may reduce these barriers. This study evaluates a targeted, asynchronous TTS training program designed for providers …

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A Case For Qualitatively Driven Mixed Methods In Nursing Research: A Methodological Discussion, Jennifer Hamilton, Cooper, Irene Ngune, Amanda Cole, Richard Bostwick, Debbie Louise Massey

Research outputs 2022 to 2026

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Mixed methodology continues to grow as a rigorous and respected research design. However, the value of qualitatively driven mixed methods research within nursing is underrepresented. Qualitatively driven mixed methods, where qualitative data dominate meaning-making, have the potential to capture critical experiential elements pertinent to nursing research while supporting empirical rigour. This methodology paper argues for the importance of qualitatively driven mixed methods approaches within nursing research to enable greater understanding of complex phenomenon. Through discussion and case example the role of qualitatively driven mixed methods, including within a sequential explanatory design, are presented. Nurses and midwives are well placed to …

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How Does Pre-Registration Child Specific Education Prepare Newly Qualified Nurses’ To Care For Children, Young People, And Their Families? An Empty Narrative Review, Matthew Carey, Edge, Julie Blamires, Mandie Foster, Sarah Neill

Research outputs 2022 to 2026

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This narrative review investigates the influence of child-specific content within pre-registration nursing programs on newly qualified nurses’ perceptions of preparedness to care for children, young people, and their families. Despite international recognition of the specialised competencies required for pediatric nursing, the proportion and quality of child-focused education across Higher Education Institutions is not clear. The Population, Exposure, Outcome framework provided a comprehensive search strategy applied across eight databases to identify relevant studies that met the inclusion and exclusion criteria. Of 663 records identified, 451 were screened and 25 full texts were assessed for eligibility by two reviewers. No studies met …

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Attitudes And Expectations Towards Acupuncture For Primary Dysmenorrhoea: Findings From A Cross-Sectional Survey In Australia, Weiting Liu, Amanda Towell-Barnard, Khui Hung Lee, Timothy Leen Kang

Research outputs 2022 to 2026

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Objective: To describe attitudes towards acupuncture and expectations regarding potential treatment outcomes among women with self-reported primary dysmenorrhoea (PD) residing in Australia. Methods: A cross-sectional, descriptive online survey was conducted to assess attitudes and treatment expectancy using an adapted version of previously published complementary and alternative medicine (CAM) attitude scale and a validated acupuncture expectancy scale (AES). Data were analysed descriptively, with exploratory analysis conducted to support the interpretation of response patterns. Ethical approval was obtained from the Edith Cowan University Human Research Ethics Committee (2023-04471-LIU) and participants provided electronic informed consent. Results: A total of 247 responses were received. …

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Trends And Indications For Cesarean Section In The Origins Birth Cohort, Kristjana Einarsdottir, Lisa Gibson, Sarah Whalan, Jacqueline Davis, Laurence Amy Payette, Ravisha Srinivasjois, Desiree T. Silva

Research outputs 2022 to 2026

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Objective: Cesarean section (CS) rates have increased substantially in Australia, with particularly high use observed in private maternity care and for pre-labor CS. The aim of the present study was to describe the CS rates and the clinical indications for pre-labor CS in the ORIGINS birth cohort.

Methods: This study analyzed data from the ORIGINS birth cohort, a large birth cohort in Western Australia, including 9473 births occurring at Joondalup Health Campus between 2016 and 2024. Rates of CS and pre-labor CS were compared across study periods (2016–2020 and 2021–2024) and by facility type (public vs. private). Indications for pre-labor …

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Time To Hang Up The Gloves: A Scoping Review Of Evidence On Non-Sterile Glove Use During Intravenous Antimicrobial Preparation And Administration, Natasya Raja Azlan, Debbie Massey, Lesley Andrew, Amanda Towell-Barnard, Seng Giap Marcus Ang, Carol Crevacore, Martina Costello, Aaron Alejandro, Weiting Liu, Naila Zaman, Peta Anne Zimmerman

Research outputs 2022 to 2026

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Aims: To systematically summarise evidence related to the use of non-sterile gloves when preparing and administering intravenous antimicrobials. Design: Scoping review. Methods: A rigorous scoping review was undertaken following Arksey and O'Malley's (2005) framework and the modified Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review guidelines (2018). Five databases and grey literature were included in the search. Literature published between 2009 and 2024 was included. Data Sources: Five databases (Medline, CINAHL, EMBASE, Scopus and Web of Science) and the grey literature were searched in February 2024. Results: Three studies were included; however, none directly addressed correct …

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How To Reduce Inpatient Violence: A Theory Synthesis From Four Models, Arthur Walker

Antioch University Dissertations & Theses

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Working in an inpatient setting inherently involves an increased risk of violence. This violence can affect both staff and patients alike and can lead to psychological trauma, serious bodily injury, and even death. To mitigate this risk, many models for preventing inpatient violence have been proposed for hospitals to implement. However, the evidence for the efficacy of these methods is inconsistent, and the theoretical underpinnings are varied and slim. This dissertation seeks to improve these models by re-examining the theoretical structures for common themes of four models for inpatient violence reduction and proposing additional recommendations informed by this synthesis. First, …

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