Digital Commons Network^™

Assessing The Impact Of Cultural Competence Training For Providers Serving Native Americans, Chinazo Obi

Doctor of Nursing Practice Projects

The United States is a culturally diverse nation, yet many healthcare providers report challenges in delivering care that respects cultural values and traditions. Within mental health settings, this gap is especially concerning for Native American populations, who experience disproportionately high rates of mental health conditions and face barriers to culturally responsive care. The purpose of this quality improvement project was to assess the impact of a cultural competence education and training intervention on mental health providers’ knowledge and self-efficacy in delivering culturally competent care to Native American patients. Guided by Leininger’s Culture Care Theory of Diversity and Universality and the …

Quality Improvement Project: The Impact Of Staff Education On Utilization Of The Phq-9 Tool And Follow-Up Management Protocol, Shuntak Jerideau

Doctor of Nursing Practice Projects

Depression is a prevalent mental health disorder that affects daily functioning. Timely screening enables the identification of symptoms, monitoring treatment efficacy, and informs additional treatment such as referrals. The practice site reported low screening rates of patient’s post-psychiatric hospitalization, which was attributed to inadequate knowledge of the PHQ-9 tool. The purpose of this quality improvement project was to evaluate the impact of staff education on the utilization of the PHQ-9 tool and follow-up management protocol in a mental health clinic. A quasi-experimental design method was used in an outpatient mental health clinic. Pretest knowledge of the PHQ-9 was obtained from …

The Mechanism Of Action Of Remote Electrical Neuromodulation (Ren) In Treating Migraine And Potentially Other Idiopathic Pain Conditions, Marius Birlea, Christopher L. Robinson, Eden Mama, Alit Stark-Inbar, Alon Ironi, Daniel Atashsokhan, Thomas Berk

College of Nursing Faculty Papers & Presentations

Purpose of Review

This review provides evidence for the mechanism of action (MOA) of Remote Electrical Neuromodulation (REN), a non-pharmacological therapeutic technology for treating migraine and other symptoms manifested by certain idiopathic pain diseases. It discusses the main physiological and anatomical aspects associated with conditioned pain modulation (CPM), and how REN is applied for the treatment of migraine pain and other symptoms.

Recent Findings

The REN wearable device (Nerivio®) is FDA cleared for acute and preventive treatment of migraine in patients aged 8 years and above, and CE marked in patients aged 12 and above. In brief, the REN MOA …

Quality Improvement Project: Impact Of Simulation Training On The Self-Efficacy Of Registered Nurses During A Code Stroke, Kakeya James

Doctor of Nursing Practice Projects

Self-efficacy levels affect decision-making skills and overall confidence in handling critical situations. However, knowledge gaps often hinder the maintenance of high self-efficacy. (Farčić, et al., 2020). The project site provides limited training opportunities that may not adequately prepare registered nurses with the confidence and skills needed to respond to stroke emergencies, potentially causing delays in patient care and adverse health outcomes. As a result, the quality improvement project aims to examine how simulation-based training impacts registered nurses’ self-efficacy in managing stroke emergencies. The project employed a quasi-experimental pretest/posttest design and was guided by the Plan-Do-Study-Act (PDSA) cycle, the Jeffries Simulation …

Quality Improvement Project: Effects Of Ongoing Clinical Education Training On Nursing Faculty’S Self-Efficacy In Clinical Education, Sarah Ferguson

Doctor of Nursing Practice Projects

Clinical education is essential for bridging theory and practice in nursing education, yet many clinical instructors transition from expert bedside nurses to novice educators without adequate orientation and training. This quality improvement project examined the effects of ongoing clinical education training on nursing faculty self-efficacy at a satellite nursing school in North Texas. This project, guided by Patricia Benner’s Novice to Expert framework and Lewin’s change model, aimed to determine whether continuous professional development throughout the term would increase clinical faculty confidence compared to standard onboarding alone. A descriptive pre/post design was used, with the Clinical Nursing Teacher Self-Efficacy Scale …

Quality Improvement Project: Improving Providers’ Self-Efficacy In Facilitating Mat Usage Through Educational Training, Joshua W. Moore

Doctor of Nursing Practice Projects

Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD) are common diseases treated in detox facilities around the world. Medication-assisted treatment (MAT) is the most effective treatment for OUD and AUD. Despite the need for MAT, many providers do not prescribe lifesaving medications due to a lack of knowledge and confidence. The purpose of this quality improvement project at a local detox facility is to answer the question: What effect on providers’ self-efficacy in facilitating MAT usage upon discharge does educational training have? Under the Social Cognitive Theory (SCT), self-efficacy was targeted using the Plan-Do-Study-Act (PDSA) change model. The aim …

Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is associated with significant health complications, including stroke, myocardial infarction, heart failure, and kidney disease. Despite advances in the treatment and management of HTN, a lack of medication adherence contributes to the persistence of HTN-related morbidity and mortality affecting men in The Bahamas. The purpose of this qualitative descriptive phenomenological study, guided by Pender’s health promotion model and Bandura’s social cognitive theory, was to explore the lived experiences of Bahamian men diagnosed with hypertension regarding their adherence to prescribed medications. Using Giorgi’s descriptive phenomenological method, in-depth, semistructured interviews were conducted with 11 participants. Data were analyzed through repeated …

Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a …

Investigating The Mediated Relationship Of Stress Between Organizational Culture And Emotional Labor In Nurses, Elaine Beardsley

2025

RESEARCH

Purpose: Pediatric critical care nurses provide essential care to severely ill or injured children, yet high stress can impact the nurse’s well-being. Although it is known that exposure to traumatic events can contribute to secondary trauma for the nurse, it is becoming more widely understood how the work environment is a contributing factor on how stress is experienced by the nurse. It is also known that emotion regulation strategies to meet organizational display rules, called emotional labor, can increase or decrease felt stress, but it is not known if this is impacted by organizational culture types. The purpose …

Characterization Of Antiretroviral Therapy (Art) Adherence Phenotypes And Psychosocial Symptom Clusters Among Black/African American (Aa) And Hispanic/Latine Adolescents And Young Adults (Ayas) With Hiv In The Adherence Connection For Counseling, Education, And Support (Access-Ii) Trial, Ann-Margaret Navarra, Taehoon Ha, Eva Liang, Maurade Gormley, David R. Garcia, Jason Fletcher, Lloyd A. Goldsamt, Michael G. Rosenberg, Karin Hasegawa, Jie Yang

School of Nursing Faculty Publications

Antiretroviral therapy (ART) adherence behavior is heterogeneous among adolescents and young adults (AYAs) with HIV and influenced by individual and interpersonal psychosocial factors. The primary objective of this study is to characterize ART adherence phenotypes and psychosocial symptom clusters, as related to ART adherence and HIV viral load suppression. This analysis included 60 AYAs with HIV enrolled in an ART adherence support clinical trial. Self-reported ART adherence at baseline, 12-weeks, and 24-weeks was used to define four ART adherence phenotypes: consistently high adherence (YY), early-only adherence (YN), late-only adherence (NY), and consistently low adherence (NN). Symptom clusters were empirically derived …

Bibbidi-Bobbidi No Boo-Boo Pulse-Oximeter: A Child-Friendly Prototype To Improve The Pediatric Experience, Holly Dickens

2025

INNOVATION & LEADERSHIP

Background: This prototype design project addresses the critical need to enhance pediatric patient comfort by reimagining common medical equipment to be child-friendly. A significant gap exists in pediatric device development, as most tools are repurposed from adult models and fail to consider the unique psychological, emotional, and developmental needs of children (Espinoza et al., 2020). Devices such as pulse oximeters, though essential in monitoring oxygenation and widely regarded as the “fifth vital sign” (Al-Beltagi et al., 2024), often cause distress for young patients. Traditional models feature intimidating adult-centric aesthetics, bright red sensor lights, and sticky wraps …

Nursing Care For The Sexual Assault Patient Using Trauma-Informed Care: Development Of Simulation Curriculum, Lauren Orr

2025

INNOVATION & LEADERSHIP

Background: In 1999, the American Association of Colleges of Nursing (AACN) called for nursing programs to include nursing care of patients who have experienced violence, including sexual violence. The care of these vulnerable patients requires specialized care, but also the use of specialized language through using trauma-informed care (TIC) to prevent revictimization and to further support healing. A simulation curriculum was developed that can both introduce the nursing care needed for a sexual assault patient and allow students to practice using TIC that is used when students practice independently as licensed nurses. Multiple studies have supported …

Evaluating The Impact Of “Three Good Things” On Professional Quality Of Life In Cardiovascular Short Stay Nurses, Alyssa Ruud

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Nursing Faculty Demographics, Attitude, Knowledge, And Integration Of Complementary And Alternative Medicine In Nursing Curriculum, Patricia L. Balistreri

Walden Dissertations and Doctoral Studies

Nurses have demonstrated positive attitudes toward complementary and alternative medicine (CAM); however, additional education is limited in nursing programs to prepare them to discuss and educate patients about these practices. Nursing faculty play a significant role in educating, mentoring, and influencing students’ knowledge levels and attitudes toward CAM. The purpose of this quantitative, non-experimental, cross-sectional study, guided by the CAM healthcare model, was to examine relationships among nursing faculty demographics, CAM knowledge, attitudes, and curriculum integration. The Knowledge, Attitudes, and Use of CAM survey was administered to 111 nursing faculty across multiple programs. Data were analyzed using multiple linear regression …

Incivility Experienced By Males In Nursing Education, Christopher S. Hale

MUSC Theses and Dissertations

Background: Nursing shortages are exacerbated by unhealthy learning environments. Men remain underrepresented among nursing students and faculty, yet their experiences of incivility are rarely examined.

Purpose: Guided by Clark’s Model of Civility in Nursing Education, this dissertation explored how male nursing students and educators in U.S. prelicensure programs experience incivility and how these patterns inform strategies to promote civility and retention.

Methods: This compendium includes (a) an integrative review of nursing faculty mistreatment using Whittemore and Knafl’s method; (b) a cross-sectional survey of male nursing educators and students using the Incivility in Nursing Education–Revised (INE-R) to estimate the prevalence and …

Staff Education On Understanding Nurse Burnout, Kathlyn Tracy Mcglynn

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice (DNP) project was a staff education program on nurse burnout, which remains a pressing issue in healthcare. Burnout is marked by emotional exhaustion, depersonalization, and a diminished sense of personal achievement. Addressing burnout within the nursing profession is important because burnout leads to job dissatisfaction, absenteeism, and turnover. The project was guided by two practice-focused questions: Will there be a change in knowledge from pre- to posttest after participating in an educational program on nurse burnout? Will the objectives of the educational program be met relative to the curriculum presented? Therefore, the purpose of …

Belonging Without Borders: A Missionary Kid Reflects On Nursing School, Julia Beth Stamp

Wisdom & Compassion: The LUSON Journal

This reflective essay examines the experience of pursuing a nursing degree while living far from home as a Missionary Kid. It explores how the absence of close family ties during nursing school intensified feelings of loneliness, challenged motivation, and strained emotional well-being. Interwoven with personal narrative and supported by recent literature, the reflection highlights the way that community— through peers, mentors, and faculty— emerged as a vital source of resilience. The essay argues that resilience in nursing education is not the product of individual grit alone but grows from interdependence and the willingness to seek and receive support. Through recounting …

Resistance Is Not Futile: Plotting A Future Of Critical Thinking With Ai In Nursing Education, Alex Boggs

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Nurse Faculty Burnout: A Narrative Literature Review, Susan Braud, Cynthia Goodrich, Amanda Martin

Wisdom & Compassion: The LUSON Journal

Background: Nursing faculty burnout significantly impairs teaching effectiveness and contributes to high turnover rates, threatening the future nursing workforce and overall quality of patient care.

Purpose: This review explores the contributing factors, consequences, and potential interventions related to nurse faculty burnout—a key driver of faculty attrition.

Method: An integrative literature review guided by the Whittemore and Knafl (2005) framework was conducted using the Melynk’s Level of Evidence Scale applied to assess the strength and quality of selected studies.

Results: Burnout in nurse faculty is multifactorial, stemming from overwhelming workloads, insufficient institutional support, and persistent systemic challenges. If unaddressed, it leads …

What Methods Do Pre-Licensure Bsn Students At A Christian University Use To Improve Resilience: A Qualitative Case Study, Beth Kelley

Wisdom & Compassion: The LUSON Journal

The purpose of this mixed-methods single-case study was to explore methods that pre-licensure Bachelor of Science in Nursing (BSN) students at a Christian university used to improve their resilience. Lazarus and Folkman's Transactional Model of Stress and Coping (1984) was employed as a theoretical framework, and the study asked: What methods did pre-licensure Bachelor of Science in Nursing (BSN) students at a Christian university use to manage stress and improve resilience? A convenience sample of 91 students was obtained to complete the demographic questionnaire, the Brief Resilience Scale, and the Perceived Stress Scale. Of those students, 25 volunteered for interviews …

Volume 3, Issue 1 - Complete Issue

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Vitamin D Deficiency And Cardiovascular Health Disparities In High-Melanin Populations: A Scoping Review, Jalen K. Luter, Silver R. Kaylor, Michael S. Boyer

Doctoral Projects

Cardiovascular disease (CVD) remains a leading cause of mortality and disproportionately affect individuals with darker skin tones, partly due to vitamin D deficiency (Sabzmakan et al., 2014). This Doctor of Nursing Practice (DNP) project uses a scoping review methodology to examine the relationship between vitamin D deficiency and cardiovascular outcomes, with an emphasis on high-melanin populations. Guided by the Joanna Briggs Institute Framework, the review synthesizes existing evidence, identifies gaps in representation and biomarker use, and highlights social and biological contributors to disparity. Databases including PubMed, CINAHL, EMBASE, and Scopus were searched, and studies were screened using standardized inclusion criteria: …

The Impact Of Peer Mentorship In Certified Registered Nurse Anesthesia Programs: A Scoping Review, Karoline Gasque, Kelly Mcreynolds, Shelia Crump

Doctoral Projects

Abstract
Problem statement: Certified Registered Nurse Anesthetist (CRNA) programs are known for
their rigorous curriculum, which predisposes Student Registered Nurse Anesthetists (SRNAs) to
challenges such as mental health issues, stress, and isolation.
Purpose: Review the literature and assess gaps in the literature to determine if peer mentorship
programs benefit SRNAs’ well-being, promote support, reduce stress, and improve retention.
Method: Databases were searched using keywords and inclusion criteria. Studies were
considered if they discussed peer mentorship in students, healthcare professionals, or nursing.
Patterns and themes were assessed to derive conclusions from the literature available. The
Population, Concept, and Context framework was …

Over Reliance On Antidepressant Medication In Long-Term Care Facilities: Rethinking Mental Health Approaches, Kaylene Elder

Walden Dissertations and Doctoral Studies

Depression is a prevalent mental health condition among older adults in long-term care (LTC) facilities and is often managed primarily through antidepressant medications. While these medications can be effective, their overuse in elderly populations increases the risk of falls, sedation, cognitive decline, and adverse drug interactions. This project addresses the need for safer, evidence-based alternatives by promoting non-pharmacological interventions that support holistic well-being. The proposed approach integrates gratitude journaling, vitamin D testing to identify deficiencies, and vitamin D supplementation for residents experiencing mild to moderate depressive symptoms. Implementation is led by nursing staff and supported by the interdisciplinary care team, …

Quality Improvement Project: Improving Competency Of Behavioral Health Technicians In Vital Sign Technique, Ashley Buescher

Doctor of Nursing Practice Projects

Untreated hypertension or hypotension can lead to serious health problems, including death. Proper technique is essential when obtaining a blood pressure reading to improve patient safety. The goal of the quality improvement project was to improve competency in blood pressure technique by implementing standardized training. The initiative addressed discrepancies in blood pressure readings in the intake unit of a behavioral health hospital. Using the Stetler Model of Evidence-Based Practice and John Kotter’s 8-Step Change Model, a single sample, pre-post design was implemented over 4 weeks. The American Heart Association's blood pressure guidelines and the Teach-Back Observation Tool were used in …

Quality Improvement Project: Debriefing In Simulation With Improved Knowledge And Confidence, Rebecca Walker

Doctor of Nursing Practice Projects

Debriefing is a vital part of simulation and is critical to the students' learning in the simulation environment. It is essential for faculty that debriefers receive training in simulation concepts and in structuring debriefings. The purpose is to improve the simulation program at the project site by implementing a training course, and the project aims to enhance the faculty's confidence and address any knowledge gaps. The project design is a quasi-experimental study that features pre- and post-intervention surveys. Fifteen full-time nursing educators were surveyed, excluding faculty who do not teach in simulation. The intervention includes launching a SBL course and …

Quality Improvement Project Assessment Of Emergency Department Staff Knowledge On Use Of Emergency Severity Index In A Critical Access Hospital: Implementation Of Emergency Department-Based Education Program., Amanda Taylor

Doctor of Nursing Practice Projects

In rural emergency departments, accurate triage is vital to ensuring patient safety and maximizing limited resources. This quality improvement project aimed to strengthen triage practices by enhancing nurses’ understanding and confidence in using the Emergency Severity Index (ESI), a standardized tool for assessing patient acuity. Ten registered nurses at a seven-bed critical access hospital participated in a structured educational program, guided by Lewin’s Change Theory and Benner’s Novice to Expert Theory. The intervention included hands-on training, real-world scenarios, and self-assessment surveys. After the program, nurses showed significant gains in both knowledge (mean scores rose from 70.0 to 88.9, p < .001) and confidence (from 13.5 to 23.2 out of 25). While the small sample size and short timeline were limitations, the results highlight the value of ongoing education in improving triage accuracy and patient care. This project offers a practical model for rural hospitals seeking to enhance emergency nursing practice and promote consistent, evidence-based decision-making.

Quality Improvement Project Step Into Serenity: How Walking Can Ease Stress For Nursing Faculty, Stefanie Martinez

Doctor of Nursing Practice Projects

This quality improvement project explored whether incorporating scheduled walk breaks could help reduce perceived stress among accelerated Bachelor of Science in Nursing (ABSN) faculty. High levels of stress and burnout continue to affect nursing educators and contribute to faculty turnover and workforce shortages. The goal of this project was to promote physical activity as a simple and accessible approach to supporting well-being and fostering a healthier work environment. Grounded in George Engel’s Biopsychosocial Model of Health, this project introduced an educational session on faculty stress, burnout, and the benefits of walking. Participants completed the Perceived Stress Scale (PSS-10) before and …

Quality Improvement Project: Creation Of An Ebp Healthy Lifestyle Program: An Evidence-Based Development Program, Devanee Ray

Doctor of Nursing Practice Projects

Nursing education is the foundation of healthcare itself. However, several things influence nursing students’ academic success. A lack of overall health habits is a significant contributor. Generally, this lack is due to a lack of education. The goal of this quality improvement Doctor of Nurse Practice (DNP) project was to develop an educational program that addresses the identified knowledge gaps. The aim was to develop the program to promote student success and pilot-test the program to determine its impact among masters-level nursing faculty. Using Lewin’s Change Theory and Orem’s theory of self-care, the educational program was piloted over a seven-week …

Educating Staff On Hourly Rounding Toward Fall Prevention In A Long-Term Care Facility, Princess Aminata Kanu

Walden Dissertations and Doctoral Studies

The identified problem at the project site facility was rising incidences of patient falls, which was attributed to insufficient staff knowledge of evidence-based strategies for preventing falls, including purposeful hourly rounding (PHR). Research has demonstrated that PHR effectively reduces the risk of falls among patients by allowing clinicians to proactively address patient needs. The purpose of this staff education project was to enhance healthcare providers’ knowledge of PHR and its role in fall prevention. The practice-focused question that guided this project was: For staff in a long-term care facility, will training on hourly rounding increase knowledge toward the goal of …