Digital Commons Network^™

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

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. …

Barriers And Facilitators To Providing Women Postpartum Care By Health Care Providers In The First 12 Months After Childbirth: A Systematic Qualitative Meta-Aggregation Review, Maryam Rouhi, Silvana Bettiol, Sarah Prior, Narges Rouhi, Theodora Dedo Azu, Christine Stirling, Lynne Staff, Linda Jones, Antigoni Leftherioti, Patricia Nicholson

Research outputs 2022 to 2026

Introduction: Postpartum care is crucial for maternal and infant health but remains inconsistently administered. This systematic qualitative review aimed to synthesize health care providers’ perspectives by exploring the barriers and facilitators experienced by health care providers in administering optimal maternal care during the first 12 months after childbirth. Methods: A systematic qualitative meta-aggregation review was conducted using the Joanna Briggs Institute methodology. Peer-reviewed qualitative studies from January 2010 to April 2024 were retrieved from MEDLINE, CINAHL, Embase, and Web of Science. Findings were mapped onto the Behavioral Model of Health Services Use. Results: Twenty-three studies were included. Four key themes …

Feasibility Of A Clinical Supervision Training Program For Mental Health Nurses: A Mixed-Methods Study, Jennifer Hamilton, Lesley Barr, Marie Boulianne, Irene Ngune, Julie Sharrock, Debbie Massey

Research outputs 2022 to 2026

Background: Clinical supervision is widely recognised as a valuable method of workplace support and professional development. Effective supervision requires clinical supervisors to be trained on theory and practice. Oftentimes, training is interdisciplinary and may not address discipline-specific needs. Aim: This study evaluated the implementation of a clinical supervision training program developed specifically for mental health nurses and informed by community and consumer involvement. Methods: A convergent parallel mixed-method design was used. A purposeful sample of 18 mental health nurses who completed the training program participated. Data collection included the Acceptability, Feasibility, Appropriateness Scale and open-ended qualitative survey responses. Quantitative data …

Effects Of Immediate Skin-To-Skin Contact In Preterm Infants In High-Resource Settings: A Systematic Review, Victoria Rettedal, Siren Rettedal, Maren Johanne Heilskov Rytter, Linea Grothe Larsen, Frederikke Buskov, Evalotte Mörelius, Katrin Mehler, Karoline Lode-Kolz

Research outputs 2022 to 2026

Aim: A landmark trial published in 2021 demonstrated a 25% reduction in neonatal mortality when comparing immediate skin-to-skin contact (iSSC) to conventional care in infants with birthweight 1–1.8 kg in low- and middle-resource settings. New evidence from randomised clinical trials on iSSC in high-resource settings has recently become available. This systematic review aimed to evaluate evidence for immediate/early SSC, defined as initiated within 1 h after birth, versus conventional care in inborn preterm infants in high-resource settings.

Methods: Ten electronic databases, including PubMed, Embase, and Cochrane CENTRAL, from 2000 until February 2026, were searched. Randomised clinical trials comparing iSSC to …

Evaluating Training Effectiveness For A Technology-Driven Pain Assessment Application: A Cross-Sectional Study, Rosemary Saunders, Peter Palamara, Seng Giap Marcus Ang, Olivia Gallagher, Michelle Gay, Irene Ngune, Lauren Jenner, Amineh Rashidi, Christopher Etherton-Beer, Jeff Hughes

Research outputs 2022 to 2026

Purpose: Appropriate pain assessment of adults is critical for effective pain management. Technology-driven tools can contribute to improved pain assessments. Training is vital when integrating new clinical digital tools. Minimal studies have evaluated post-training outcomes. The aim of this study was to evaluate the training provided to clinical staff on the use of a pain assessment application for hospitalized adult patients. Design A cross-sectional study utilizing The Kirkpatrick Model of Training Evaluation.

Methods: Clinical staff (nurses and physiotherapists) on an acute metropolitan hospital orthopedic ward in Western Australia were invited to face-to-face training of PainChek Universal, a pain assessment application …

National Consensus On The Capabilities That Inform The Role Of Advanced Practice Paramedics: A Delphi Study, Alessia Restiglian, Lorna Martin, David Long, Louise Reynolds, Tony Walker, Ben Meadley, Ashleigh Finn, Alan Batt, Alecka Miles, Tania Johnston, Brendan Shannon

Research outputs 2022 to 2026

Advanced Practice Paramedics (APPs) are highly skilled paramedics who operate in diverse clinical settings both within and outside traditional ambulance services. International evidence demonstrates that APPs enhance patient outcomes in areas such as critical and primary care. In Australia, the expansion of APP roles and responsibilities has gained momentum; however, no nationally recognised framework exists to define their expected capabilities. This gap leads to inconsistencies in education, practice and role clarity. A standardised capability framework is therefore vital to guide the development, implementation and integration of APP roles within the Australian healthcare system. The primary aim of this study was …

Push Dose Vasopressors For The Treatment Of Hypotension, Jennifer Ann Dailey

Doctor of Nursing Practice (DNP) Scholarly Projects

Millions of Americans experience life-threatening hypotension. Prolonged hypotension results in acute kidney injury, myocardial injury, even cardiac arrest, and is associated with increased morbidity and mortality (Khanna et al., 2019; Schuurmans et al., 2024; Singer et al., 2022). Hypotension and its associated complications result in higher hospital costs (Keuffel et al., 2018). While there is a high incidence of hypotension among ICU patients, a smaller percentage of patients require vasopressor infusions regionally and nationally (Moin et al., 2025; Pollard et al., 2019). Local data from a community hospital within a North Texas suburb demonstrates a larger percentage of ICU patients …

Sustainable Healthcare In Action: Six Practice Changes That Make A Difference, Christine Catling, Carol Crevacore, Melisa Young, Wayne Varndell, Jack Cornish, Sue Sheppard-Law, Elaine Correia Moll

Research outputs 2022 to 2026

Problem: Planetary health, linking the well-being of human populations with the stability of Earth's natural systems, is increasingly recognised as essential for all organisations. Healthcare is a major contributor to environmental harm, responsible for an estimated 4.4% of global net emissions. As a result, healthcare workers have an important role in driving sustainable, low-waste practices within clinical settings. Aim: This paper outlines six practical, evidence-informed changes that can be introduced within healthcare organisations: adopting reusable tourniquets, reducing unnecessary glove use, recycling medication blister packs, promoting reusable nappies, using reusable or compostable blueys, and reintroducing stainless steel holloware. Discussion: These examples …

The Contribution Of Nursing And Midwifery To Achieving The Sustainable Development Goals: A Bibliometric Analysis, David C. Benton, Andrew D. Benton, Kate Buchanan, Gemma Doleman, Karen Strickland, Lisa Whitehead

Research outputs 2022 to 2026

Background: Nurses and midwives are central to achieving the Sustainable Development Goals (SDGs) as the largest regulated sector of the global health workforce and as professions explicitly encouraged by the International Council of Nurses and the World Health Organization to advance the 2030 Agenda. This paper updates a 2016 bibliometric analysis to examine changes in nursing and midwifery scholarly engagement with the SDGs.

Methods: A bibliometric analysis of Scopus, CINAHL Ultimate, and PubMed was undertaken for publications from 2000 to 2025 containing Millennium Development Goal (MDG) or Sustainable Development Goal (SDG) terminology in nursing and midwifery literature. VOSviewer was used …

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

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 …

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

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 …

Voice Your Choice, Sarah Olson, Mercy Bustamante-Vizarretea, Hannah Bauman, Sally Hall

SPARK Symposium Presentations

Our proposal seeks to develop and implement a standardized Charge Nurse Interest Survey which will create a structured process for identifying those most interested and best suited for the position of charge for all registered nurses on a local med-surg unit. Nurses on this unit are appointed and eligible to serve in the charge nurse role after six months of experience on the unit. Research shows that charge nurses who demonstrate emotional stability, composure under pressure, strong organizational skills, and proactive planning contribute to improved team functioning and decreased workplace strain (Gottlieb & Gøtzsche-Astrup, 2018).

To clarify the charge nurse …

Don't Let Them Fall, Let Ai Call, Ella Mills, Sara Barker, Andreea Ifrim, Yvette Uwase

SPARK Symposium Presentations

This project proposes a nurse-led pilot of AI-supported predictive mobility monitoring on a cardiac medical-surgical unit, to improve early identification of high-risk mobility behaviors and enhance patient safety. Current fall-prevention strategies, such as bed alarms and virtual sitters, often alert staff after unsafe movement has begun, creating a reactive cycle that contributes to alarm fatigue and delayed intervention (Abbe & O’Keeffe, 2020). This initiative uses monitors with contactless infrared sensors to identify movement before patients exit the bed, an alert system that goes straight to the nurse and PCT phones, and a central console for floor management and care coordination. …

Reducing Exacerbation In Patients With Chronic Obstructive Pulmonary Disease To Decrease Hospital Admission Rates, Sasha Gonzalez

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Chronic obstructive pulmonary disease (COPD) exacerbations contribute to avoidable acute care use, diminished quality of life, and substantial healthcare costs. This quality improvement project evaluated an eight-week COPD exacerbation prevention bundle in a Texas internal medicine clinic.

Methods: The project included adults aged 50 years and older with a history of acute COPD exacerbation and prior hospitalization. Sixty patients comprised the specified project population. The bundle incorporated structured follow-up, use of COPD self-management and action plans, vaccination assessment and education, and individualized smoking-cessation support.

Results: Outcomes were evaluated descriptively by comparing the May 18 through July 12, 2026, implementation …

Standardized Sdoh Screening To Improve Obesity Management In Primary Care, Janessa Webster

Doctor of Nursing Practice (DNP) Scholarly Projects

Obesity is a complex chronic condition disproportionately affecting marginalized populations, with outcomes heavily influenced by Social Determinants of Health (SDoH). In primary care, a lack of standardized SDoH screening often leaves critical social barriers unrecognized, hindering lifestyle modification and weight management efforts. This quality improvement project evaluated implementing the standardized Core-5 SDoH screening tool in adult patients (BMI ≥ 30) during obesity management visits over eight weeks. Before implementation, we independently verified local community resources to confirm active capacity. The project increased the standardized screening completion rate from 0% to 100% (n = 77) among eligible encounters. Of the 77 …

Improving Home Glucose Monitoring And Diabetes Self-Management In A Nonprofit Primary Care Setting, Poonam Misra

Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes requires consistent self-management support to promote glycemic control and reduce complications. This eight-week quality improvement project implemented a standardized diabetes self-management care bundle for adults with type 2 diabetes and hemoglobin A1c greater than 7% in a nonprofit primary care setting. The quality improvement project was guided by the Plan-Do-Study-Act framework. The intervention incorporated self-monitoring of blood glucose (SMBG) review and provider feedback, medication adherence assessment, prescription review in the patient’s preferred language, diabetes self-management education and support reinforcement, nutrition counseling or dietitian referral, and follow-up planning. Thirty patients were consecutively enrolled. Following the implementation, medication adherence …

Non-Pharmacological Interventions For The Management And Prevention Of Hypertensive Disorders In Pregnancy: A Review Of The Literature, Shenelle K. Smith, Laurena E. Lepp

All Electronic Theses and Dissertations

Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE), are a leading cause of maternal and perinatal morbidity and mortality worldwide. In the United States, rates of HDP continue to rise and are associated with preterm birth, fetal growth restriction, and long-term cardiovascular disease. Current management focuses only on low-dose aspirin for prevention. Surveillance and timely delivery remain the only definitive treatment for preeclampsia. This highlights a critical gap in prevention. Emerging evidence suggests that non-pharmacological interventions–particularly nutrition, physical activity, and lifestyle modification–may reduce the risk and severity of HDP. These approaches align with midwifery models of care emphasizing prevention, education, …

Fear Of Childbirth As A Perinatal Comorbidity: An Integrative Review, Michelle T. Mcmanus, Ashely N. Payne

All Electronic Theses and Dissertations

Fear of childbirth (FOC) and tokophobia have a significant impact on one in every five pregnant women and is associated with enhanced levels of anxiety, depression, pre-traumatic stress, and has led to increased requests for elective cesarean sections. Given the influence that it has on birth mode and perceived birth experience as well as postpartum wellbeing, it stands to reason that FOC represents an often-overlooked aspect of perinatal mental health.
This capstone reviews cohort, cross-sectional, randomized, and quasi-experimental studies examining prevalence, correlations, and consequences of FOC. It evaluates antenatal education, midwife-led support, and cognitive behavioral therapy as potential interventions. Outcomes …

Elevated Bmi And The Effect On Breastfeeding Duration In Postpartum Individuals: An Integrative Review, Abigail E. Mobilia, Kirstin A. Wyly

All Electronic Theses and Dissertations

Introduction: It has been well documented that exclusive breastfeeding provides benefits for infants and postpartum individuals, yet rates remain suboptimal in the United States, particularly among those with elevated pre-pregnancy body mass index (BMI). Evidence suggests that elevated BMI is associated with shorter breastfeeding duration and may be influenced by physiologic, social, and structural factors. This integrative review synthesizes existing literature to clarify the relationship between elevated BMI and exclusive breastfeeding duration among postpartum individuals.
Methods: An integrative review was conducted following Whittemore and Knafl’s (2005) framework and PRISMA 2020 guidelines. A systematic search of PubMed, CINAHL, and Nursing & …

Gestational Diabetes Mellitus And Its Psychological Impacts During Pregnancy And Postpartum, Nehemie B. Hypolite, Charline Fast

All Electronic Theses and Dissertations

Introduction: This review explores the link between gestational diabetes (GDM) and psychological outcomes. GDM affects 8–10% of pregnancies and is typically diagnosed at 24–28 weeks. This burden leads to anxiety, depression, and fear. Postpartum concerns often persist for mother and infant.

Methods: Whittemore and Knafl’s (2005) method was used to synthesize data. The research databases included CINAHL and PubMed. Covidence supported screening and PRISMA diagram development. Key search terms included “anxiety and GDM,” “depression and GDM,” “GDM and postpartum depression,” “gestational diabetes,” and “pregnancy.” Inclusion criteria included full-text articles published after 2010, original studies, patients undergoing diabetic treatment (medication and/or …

The Impact Of Patient-Centered Care On Women With Infertility And Pregnancy Loss: An Integrative Review, Kaidynce R. Sweazy

All Electronic Theses and Dissertations

Introduction: Infertility affects roughly 17.5% of adults worldwide, while pregnancy loss occurs in up to 30% of pregnancies. These reproductive traumas increase the risk of developing a mental health disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD). The purpose of this review is to identify the influence of patient-centered care on psychological outcomes and experiences of care in women with infertility and pregnancy loss.
Methods: A literature search of the PubMed and Cinahl databases was conducted for original studies published from January 2016 to January 2026 that address the psychological outcomes and/or experiences of women who experienced infertility …

The Placenta & Covid-19: Histological Changes & Clinical Implications, Melissa F. Paul, Allyson J. Zadlo Sensor

All Electronic Theses and Dissertations

Introduction: The COVID-19 pandemic presented the medical community with complex and novel challenges, not the least of which is how to optimize prenatal and postnatal care for pregnant individuals who have been infected. At present, seven years have elapsed, and despite definitive research demonstrating adverse outcomes associated with placental changes, no professional consensus has been reached.
Methods: This integrative review includes studies involving pregnant individuals with confirmed SARS-CoV-2 infection, who recovered during the same pregnancy, and their infants. An examination of the data available reveals a triad of placental pathologies (chronic histiocytic intervillositis, perivillous fibrin deposition, and trophoblast necrosis) that …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

Master's Theses or Doctor of Nursing Practice

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Advanced Practice Workforce: ​Drivers Of Satisfaction & Retention​, Stephanie Bork, Amber Balzer, Sally Russell, R. K. Elswick Jr., Terry Jone, Kimberlee Ketchersid, Joseph Deranieri

School of Nursing Publications

Problem

The turnover of advanced practice registered nurses (APRNs) is costly for institutions and creates gaps in care for organizations. The aims of this study are to describe the characteristics of the APRN and PA workforce in a large, integrated academic medical center and examine relationships between APRN and PA workforce characteristics and organizational outcomes.

Background

APRNs encompass a diverse group of licensed clinicians and are integral to healthcare delivery. As APRNs roles expand to support healthcare needs, turnover is costly and adversely affects patient care. The APRN role remains constrained in many healthcare institutions, contributing to burnout and job …

Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Student Research Posters

No abstract provided.

Moving Forward Together For Cancer Recovery: Collaborative Guide For Researchers And Cancer Care Organizations, M. Madison Kindred, Karen E. Wickersham, Daneille E. Ostendorf, Bernardine M. Pinto

Faculty Publications

No abstract provided.

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Reducing 30-Day Readmission Rates In Patients With Heart Failure, Charles Mccoy

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Globally, heart failure affects approximately 54 million individuals and has reached pandemic levels, contributing to elevated 30-day readmission rates (Sa et al., 2024). Background: In the United States, 30-day readmission rates range from 18% to 20%, with similar rates across all states. The current rate was documented as 29% at the study setting hospital. Objective: Implement a Quality Improvement project based on education, evidence-based order sets, and referral to palliative care to reduce 30-day readmission rates among adults with heart failure. Methods: Nursing staff completed education specific to heart failure, and patients received the American Heart Association Self-Check assessment. …

Ask, Advise, And Act: A Smoking Cessation Bundle For Cancer Patients, Crystal Tencate

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Smoking is the number one cause of preventable illness and death in the United States. For patients undergoing cancer treatment, continued tobacco use poses serious risks. In surgical oncology, smoking is associated with poorer treatment outcomes, increased postoperative complications, delayed wound healing, and higher mortality. For patients requiring reconstructive surgery, smoking-related complications can be devastating, sometimes resulting in significant wound complications or loss of the reconstruction. Despite these well-established risks, smoking cessation interventions are not consistently integrated into clinical practice.

To address this gap, a quality improvement project was implemented to strengthen smoking cessation efforts among advanced practice providers (APPs) …

Nursing Bundle To Improve Quality Metrics For Postoperative Patients, Kristine G. Coronado

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Postoperative pulmonary complications and inconsistent implementation of preventive nursing interventions remain significant challenges on acute care surgical units. The purpose of this quality improvement project was to reduce postoperative respiratory failure, hospital readmissions, and length of stay while improving nursing compliance with evidence-based interventions. A nursing care bundle, RISE—Respiratory therapy (structured, nurse-guided incentive spirometry), Incentivize movement (early ambulation), Sit up (head-of-bed elevation ≥30 degrees), and Eliminate germs (twice-daily oral care)—was implemented on an acute care surgical ward in South Texas. Nursing compliance with the preventative measures and patient outcomes were compared between pre- and post-implementation cohorts. Following implementation, nursing compliance …