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Building A Common Language For Diaper Dermatitis Assessment: A Nurse Education Quality Improvement Project Using The Visscher Skin Integrity (Vsis) Scale In A Safety-Net Nicu, Kishorie Weingart, Michelle Hart, Alyssa Garcia, Naomi Del Barrio

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Globally, skin injury related to diaper dermatitis remains a pervasive yet preventable threat to neonatal patients (Jaieyoba and Visscher, 2025). In fact, the Jani et.al. 2022 study found that diaper dermatitis is the most frequently reported skin injury in premature infant patients across NICU units globally at 39%, with NICU patients in North America having a significantly higher rate of diaper dermatitis of 62%, juxtaposed to European NICU patients at 31% (Jani et.al., 2022). However, numerous studies found that implementation of a standardized skin assessment tool was a key factor in reducing rates and/or severity of perineal skin injury (Ahmadizadeh …

Competency Campfire Stories: S'Mores & Skills, Competency & Curriculum, Sparks & Social Media, Emily Bovino Msn, Rn, Cnl, Ccrn, Michael Defrancisco Msn, Rn, Britney Meunier Msn, Rn, Ccrn, Amy Stafford Dnp, Aprn, Ccns, Kristen Stogsdill Bsn, Rn, Ccrn

MaineHealth Maine Medical Center

Learning Objectives

• Identify strategies to foster connections and build confidence among new nurses by creating a supportive, interactive learning environment.

• Describe how to design and facilitate the Camp Competency onboarding experience to engage new nurses through interactive learning.

• Incorporate social media tools to enhance learner interaction and community-building.

From Evidence To Action: Optimizing Ards Care In The Icu, Amy Stafford Dnp, Aprn, Ccns

MaineHealth Maine Medical Center

Objectives

• Define ARDS using historical and current diagnostic criteria

• Explain the pathophysiology of ARDS and its impact on lung mechanics, including compliance, driving pressure, and recruitable lung

• Recognize limitations of common monitoring tools, including pulse oximetry, and incorporate this into clinical decision-making

• Apply evidence-based management strategies for ARDS, including lung protective ventilation, PEEP optimization, proning, and adjunctive therapies

• Analyze clinical case scenarios to make decisions related to ventilator management, oxygenation strategies, and escalation of care

Changing Culture Through Shared Passion: How We Found Our Identity In The Medical Icu, Lorrie Sluti Bsn, Rn, Ccrn, Alison Griffin Bsn, Rn, Ccrn, Megan Massey Bsn, Rn

MaineHealth Maine Medical Center

The purpose is to examine the cultural transformation of a Medical Intensive Care Unit after the COVID-19 pandemic; highlighting how the development of a Unit-Based Practice Council restored unit identity, nursing job satisfaction, and improved patient outcomes.

Facilitators And Barriers To Teach And Assess Clinical Judgment In The Context Of Ngn And Interpreted Through The Nln Framework, Patricia L. Pence, Seon Yoon Chung, Lisa D. Broderson, Vicki Moran, Myoungjin Kim

Faculty Publications - Mennonite College of Nursing

Background

The shift to Next Generation NCLEX (NGN) requires that nurse educators (NEs) align strategies to teach and assess clinical judgment (CJ). However, gaps remain in NEs' formal preparation to effectively teach and assess CJ as they prepare graduates for success on the evolving licensure examination.

Purpose

This study identified facilitators and barriers to teaching and assessing CJ within the context of NGN.

Method

A descriptive cross-sectional survey was conducted with 143 NEs across the United States (September 2022–April 2023). Findings were interpreted through the National League for Nursing (NLN) Core Competencies and Scope of Practice framework rather than reported …

How Social Media And Cyberbullying Correlate To Eating Disorders In Adolescents, Nicoli A. Panelo

Nursing | Senior Theses

Background: Social media is very prevalent in today’s society, particularly in adolescents. This time period is crucial for this age group in terms of developing a sense of purpose and identity. Although social media may keep many of our children entertained, they also can create negative impacts on them and ultimately hinder their overall development both mentally and physically through negative body image and unrealistic self-expectations. Purpose: The purpose of this study is to find the correlation between social media use and the rise of eating disorders in adolescents. Doing so would allow us to find ways to lower the …

Supporting New Graduate Nurses: Residency, Mindfulness, And Simulation, Shaianne Kaye S. Intal

Nursing | Senior Theses

The purpose of this research proposal is to examine the effectiveness of support systems in helping new graduate nurses bridge the potential gap between nursing education and clinical practice. It aims to address the inconsistencies in nursing education and clinical practice, and how these strategies can better support new graduate nurses. This study will focus on new graduate nurses within their first 2 years of practice in an inpatient setting. A mixed-methods convergent parallel design approach will be used by combining quantitative questionnaires with qualitative interviews at the same time. This will evaluate the effectiveness of nurse residency programs, mindfulness-based …

Exploring Dominican University Nursing Students’ Perceptions Of Economic Barriers To Accessing Essential Women’S Health Products, Annabelle E. Burke

Nursing | Senior Theses

Period poverty is defined as inconsistent or inadequate access to feminine hygiene products, and it has been shown to negatively impact physical and mental health, academic performance, and dignity across diverse populations. Existing research highlights financial strain, social stigma, and insufficient support as key barriers to menstrual equity among individuals experiencing homelessness, adolescents living in low-resource environments, low-income women, and general undergraduate students (Brinkley & Niebuhr, 2023; Dave et al., 2022; Gruer et al., 2021; Lahme et al., 2018; Parkinson et al., 2024; Gilchrist et al., 2024). However, no studies have examined these issues amongst Dominican University nursing students who …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Senior Theses

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

The Impact Of Parental Mental Health On Infant Outcomes In The Neonatal Intensive Care Unit: Length Of Stay, Feeding, Bonding, And Developmental Progress, Andee L. Plaskett

Nursing | Senior Theses

Background: The neonatal intensive care unit (NICU) can be a highly stressful environment for both infants and their parents. Poorer infant outcomes, including longer hospital stays, feeding difficulties, and delayed developmental progress can all be a reflection and outcome of elevated parental distress. Currently, mental health distress and infant screening tools are used in most NICUs but are not seen in all practices, it is also important to provide interventions based on the screening results. Screening tools are used to identify a problem but interventions should be implemented to try to alleviate the problem. Objective: By implementing a standardized screening …

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

Comparing Nurse-Led Holistic Pain Relief Strategies And Sole Pharmacological Use In Enhancing Maternal Satisfaction, Reducing Pain, And Lowering Obstetric Interventions During Childbirth, Jessica C. Moore

Nursing | Senior Theses

Background: Childbirth has become heavily reliant on pharmacological management and obstetric interventions such as epidural use, labor induction, and cesarean deliveries (C-sections) even among low-risk pregnancies. While necessary in some cases, excessive reliance on pharmacological interventions can negatively impact the experience of birthing as a whole. Non-pharmacological interventions (NPIs) such as breathing techniques, positioning, hydrotherapy, massage, aromatherapy and continuous support have shown to be effective in reducing pain and supporting physiologic labor. The gaps in education and lack of standard implementation result in inconsistent application in practice. Purpose: This research proposal aims to evaluate the effectiveness of nurse-led NPIs compared …

Human Milk Feeding And Its Impact On The Incidence Of Necrotizing Enterocolitis, Maya C. Kern

Nursing | Senior Theses

One of the leading causes of morbidity and death for preterm and very low birth weight (VLBW) newborns is still necrotizing enterocolitis (NEC). Existing literature consistently shows that the bioactive, anti-inflammatory, and microbiome-supporting components of human breast milk, including donor human milk, significantly lower the incidence of NEC. However, a lot of infants are forced to rely on formula and nutrient fortifiers because they cannot obtain maternal or donor milk. A critical gap persists regarding whether human milk derived fortifiers offer greater NEC protection than bovine derived fortifiers in infants who must receive formula. This thesis examines three interconnected themes; …

Developing An Educational Session And Epic-Based Tools To Help Nurses Provide Culturally Sensitive Care To Their Muslim Patients, Laila Albutmeh

Nursing | Senior Theses

Background: Islam is currently the fastest growing religion in the world and the chances of nurses having a Muslim patient is exceptionally high yet many nurses lack the knowledge and resources on how to accurately provide culturally sensitive care to Muslim patients. Hospitals lack educational sessions/training as well as Epic tools to help nurses provide culturally sensitive care to Muslim patients which leads to a knowledge deficit in cultural sensitivity of Islamic beliefs, values, and practices. Purpose: This thesis paper proposes a research design for a nurse education/training program on Islamic beliefs, values, and practices along with an implementation of …

The Effects Of Strong Parental Support And Societal Support Compared To Low Or Absent Support In Lgbtqia+ Youth, Kassandra Bautista

Nursing | Senior Theses

Background: LGBTQIA+ youth with unsupportive backgrounds face negative outcomes in their mental health. Past studies share that LGBTQIA+ youth have increased symptoms of mental illness including depression, anxiety, and suicidal thoughts and behaviors related to unsupportive environments among parents, peers, and society. Objective: By advocating for this minority group through education and culturally competent care, healthcare providers can reduce negative outcomes in the mental and physical well-being of the youth. Purpose: The purpose of this study is to address the impact of parental and societal support in LGBTQIA+ mental health, and to implement interventions and increase awareness of this issue. …

Blister Packaging Versus Bottles: Caregiver Accuracy And Child Safety In Pediatric Medication Gummy Administration, Paolo Olimpiada

Nursing | Senior Theses

The safety of medication in pediatric settings has become an increasing concern as gummy-formulated medications have gained popularity in children’s care. Gummy-formulated medications have a close resemblance to candy, and this may mislead children to ingest additional doses or more than what was prescribed. Children also depend a lot on their caregivers for medications. Therefore, the design of packaging would be impactful in supporting medication dosing accuracy. And studies have evaluated safety features of packaging related to adherence, misuse, and unintended administration. However, limited studies have examined the influence of medication packaging on the dosing accuracy at the time of …

Routine Guided Meditation In Nicu Nurses: A Coping Strategy For Nicu Nurses Dealing With Newborn Deaths, Gianna Wong

Nursing | Senior Theses

Purpose: This research study aims to investigate the emotional impact of newborn deaths on Neonatal Intensive Care Unit (NICU) nurses in addition to evaluating their perceptions of routine guided meditation as an effective coping mechanism to manage professional grief and enhance psychological well-being. Methods: Utilizing an exploratory descriptive research design grounded in Pender’s Health Promotion Model (HPM), this study examines the lived experiences and health-promoting behaviors of neonatal nurses following newborn deaths. Data: Anticipatory collection of data will be from a sample of NICU nurses based in California through a twelve-question survey featuring open-ended questions. Qualitative content analysis will be …

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

Social Work Dissertations

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 …

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.

Improving Hypertension Medication Adherence In Rural Southern Mississippi Minority Adults With Implementation Of A Patient Hypertension Education And Adherence Toolkit (Heat), Loni M. Brown

Theses

Non-adherence to medication treatment planning is a pervasive and challenging issue in health care, especially among patients with hypertension. Statistically, inadequately controlled hypertension due to non-adherence to treatment is most prevalent among Black and Hispanic Americans in the southern United States (Hayes et al., 2022). Particularly, hypertension within southern rural communities reflects substantial socioeconomic factors and health disparities influencing medication adherence (Besel et al., 2023). Minority adults over age forty, face increased health barriers to adequate treatment (Wilder et al., 2021). Moreover, the prevalence of hypertension medication non-adherence is notably higher in rural areas nationally (Besel et al., 2023). Black …

Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin

West Chester University Graduate Theses, Dissertations, and Final Projects

Point-of-care testing (POCT) is used to measure a variety of healthcare data rapidly at the bedside. It can be particularly useful when laboratory data is not available at the time a patient sees their healthcare provider (HCP). Patients living with diabetes frequently do not obtain laboratory data prior to their visit with their HCP. This quality improvement projected aim to assess if use of POCT to measure an Hgb A1c level in patients with diabetes affected patient satisfaction in an endocrinology clinic. Eligible participants were asked to complete an anonymous survey, with three questions asking if having their Hgb A1c …

Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

The Effectiveness Of Virtual Reality Aggression And Violence De-Escalation Training For Nursing And Midwifery Students: A Quasi-Experimental Study, Joshua Johnson, Brennen Mills, Luke Hopper, Sara Hansen, Kelley Mumford, Renju Joseph, Susan Philip, Gina Kruger, Abdi D. Osman

Research outputs 2022 to 2026

Background: Nursing students experience substantial exposure to aggression and violence while attending clinical placement. De-escalation training can effectively prepare students for aggressive encounters, yet is resource-intensive to deliver. Immersive virtual reality (VR) may improve training accessibility for nursing students. Aim: To evaluate the effectiveness of a VR de-escalation training program to improve nursing students’ confidence in managing patient aggression and its perceived usability. Methods: This study utilized a single-group quasi-experimental pre-/post-test design. Undergraduate Australian nursing students (n = 221) completed a VR de-escalation training program, providing pre-/postintervention self-reported confidence in coping with patient aggression, system usability, and motion sickness data. …

A Survey Of Nurses’ Knowledge Of Evidence-Based Guidelines For Indwelling Urinary Catheter Care, Linda Coventry, Michelle Gay, Amineh Rashidi, Anke Ebeling, Roshnika Fernando, Christine Hallauer, Manjari Jayarathna, Rashmi Shrestha, Blake Smith, Paige Watkins, Rosemary Saunders

Research outputs 2022 to 2026

Background: Urinary tract infections are one of the most common healthcare-associated infections, with catheter-associated urinary tract infections being a significant burden on healthcare systems globally. Aim: To assess nurses’ knowledge of evidence-based indwelling urinary catheter care and explore the barriers and facilitators of evidence-based indwelling catheter care. Design: A cross-sectional survey-based study of nurses in an acute private hospital in Western Australia was conducted from March 2021 to April 2021. Methods: Respondents were recruited using a convenience sampling method. The questionnaire included (1) demographics, knowledge of: (2) indications, (3) catheter care, (4) catheter-associated urinary tract infections prevention, and two open-ended …

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

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 …

Bias In Nursing Students: How Student Exposure Impacts Patient Interactions, Claire Roy

Honors Theses and Capstones

Bias is a pervasive issue in healthcare. It affects all aspects of the healthcare system and affects patients primarily through their interactions with healthcare providers. This study aimed to identify if exposure to various patient populations reduced bias among participants and increased their understanding of the way bias impacts patients. Two participants were recruited from a baccalaureate nursing program course titled “Living with Mental Illness” to participate in a series of two-semi structured interviews to identify bias, perceptions of community-based care, and the growth from the beginning to the end of their clinical experiences. Results showed skill development, increased understanding …

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Barriers To Mental Healthcare In Rural Agricultural Communities, Monica Salonga

Research Honors

Mental health diagnoses have become increasingly concerning in the United States (US). In 2024, 60 million adults in the United States experienced a mental illness, and over 14 million adults stated they had suicidal thoughts (Reinert et al., 2025). The Center for Disease Control (CDC) reports around 4,000 suicide-related deaths in the United States every year (CDC, 2025). One population that suffers from disproportionate rates of suicide is farmers and farm families. Farmers are ranked #4 in the United States regarding suicide rates (Miller & Rudolphi, 2022). Between 2003 and 2018, there were 1,935 suicide-related deaths committed by farmers (Miller …