Digital Commons Network^™

Improving Compliance Via Barcode Scanning With Rover App, Jeni Varghese, Lilia Preston

Articles, Abstracts, and Reports

Purpose: The purpose of the project was to increase compliance with interoperability workflows through implementation of barcode scanning using the Rover app. The goal was to streamline electronic medical record (EMR) programming and overcome workflow challenges.

Background: Infusion interoperability links EMR systems with smart infusion pumps to streamline programming and monitoring. Orders are sent directly from the EMR to the pump, nurses verify settings, and infusion data is relayed back for documentation, reducing manual input and enhancing patient safety by minimizing errors. Current interoperability workflow includes the use of handheld scanners located on computers.

Hospital benchmark for interoperability …

Mental Health Effects Of Post-Intensive Care Syndrome In Adult Acute Respiratory Distress Syndrome Survivors Hospitalized During Or After The Covid-19 Pandemic, Brooke M. Leggiero

Honors Undergraduate Theses

Introduction: Post-Intensive Care Syndrome (PICS) is "new or worsening problems in physical, cognitive, or mental health status arising after a critical illness and persisting beyond acute care hospitalization.” This study examined the prevalence of PICS mental health conditions in adult ARDS survivors hospitalized between 2020 and 2025 and differences in mental health conditions between those hospitalized during and after the COVID-19 pandemic.

Methods: This retrospective, descriptive, cross-sectional study enrolled adult survivors hospitalized between 2020 and 2025 who required mechanical ventilation and were at least 1 month removed from the intensive care unit (ICU). Individuals with prior brain injury were excluded. …

Enhancing Stroke Recovery: A Proposal To Implement Self-Efficacy Strategies In Rehabilitation, Ariana M. Allen, Elliott P. Mcneely

Williams Honors College, Honors Research Projects

Self-efficacy is a critical predictor of rehabilitation success in stroke survivors, influencing motivation, therapy adherence, and functional recovery. This study will investigate the current use of structured self-efficacy enhancement programs (SEEPs) by healthcare professionals in post-stroke rehabilitation settings. Guided by Bandura's Self-Efficacy Theory, this proposal outlines a study that will include a comprehensive literature review and suggestions for further research. It will explore the frequency and methods of SEEP use, including goal setting, motivational feedback, and graded task planning. Data would be analyzed through descriptive statistics and thematic analysis. Findings are expected to identify usage patterns, barriers, and opportunities to …

Magnifying Mental Health In The Perinatal Population: A Systematic Review, Kasey E. Arnold, Alyssa M. Maki

Williams Honors College, Honors Research Projects

Pregnant individuals often experience significant anxiety, which can negatively affect both pregnancy and fetal outcomes. This systematic review evaluates the effectiveness of pharmacologic versus non-pharmacologic anxiety-relieving interventions, primarily focusing on the labor period. The PICOT question is: In perinatal patients, do non-pharmacologic anxiety-relieving measures, compared to pharmacologic anxiety-relieving measures, have a greater impact on ease of delivery and overall mental health during pregnancy and the perinatal period? PRISMA (2020) guidelines were used with inclusion criteria of human subjects, English language, and published within the last six years. Databases included PubMed, CINAHL, and Cochrane Library. Twenty-three studies were analyzed to examine …

Nurse Workforce Outcomes: 8-Hour Vs. 12 Hour Shifts Among New Graduate Nurses, Jared Boyd, Lauren Kim, Gisel Olvera, Lauren Rifkin, Berenice Saldana, Marc Soriano, Bailee Tobias, Angela Torre

Publications 2026-present

No abstract provided.

Management Of Medication Nonadherence In Adults Diagnosed With Schizophrenia, Olukemi O. Adeogun

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Individuals diagnosed with Schizophrenia have high medication nonadherence rates, which increase the risk of symptom relapse and hospitalization. This evidence-based practice (EBP) project sought to reduce antipsychotic medication nonadherence among adult patients diagnosed with schizophrenia and/or schizoaffective disorder. Methods: Twenty-six individuals aged 18 and older participated in the project over 8 weeks. A pretest-posttest design was applied to measure participants' self-reported medication adherence scores before and after implementing a medication adherence bundle. The intervention included psychoeducation, long-acting injection (LAI), and phone reminders. Paired t-tests were used to compare the pre- and post-test Medication Adherence Report Scale-5 (MARS-5) scores.  The …

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Publications 2026-present

No abstract provided.

Does Utilization Of Education In The Rural North Carolina Christian Community Reduce Vitamin D Deficiency, Alyssa Dedmon

Doctor of Nursing Practice Projects

Background: Vitamin D deficiency is a prevalent and underrecognized health issue, especially office workers who are exposed to less midday sun. Education and awareness may help address this risk.

Purpose: This project aimed to evaluate whether education on light therapy and vitamin D supplementation improves knowledge related to prevention and management of deficiency.

Methods: Participants from a rural North Carolina church community completed a pre-test, viewed an educational video, and completed a post-test to assess changes in knowledge. The intervention addressed risk factors, cultural influences, and treatment options.

Results: Participants demonstrated strong baseline knowledge, with modest improvements post-intervention, particularly in …

Human Trafficking: The Lack Of Education In The Christian Community, Sabrina L. Locklear

Doctor of Nursing Practice Projects

One of the most serious public health problems in the United States, as well as worldwide, is human trafficking. This criminal activity affects over 25 million adults and children worldwide annually (Olivieri et al., 2024). One of the largest allies against human trafficking is faith-based communities. These organizations have strong relationships with the community and play a major role as key stakeholders in the fight against human trafficking (Hounmenou, 2023). The Christian Community is a service-driven group that helps those who are in destitution. Evangelical Christian Pastors in the United States Midwest acknowledge that their congregations struggle when they try …

The Effectiveness Of Cardiovascular Disease Education In The African American Church With African American Women, Aricka H. Thurman

Doctor of Nursing Practice Projects

Cardiovascular disease in African American women is one of the leading causes of death in the United States and in rural communities due to the lack of awareness and prevention of the disease. Many African American women are the foundations of their homes and community, and any signs of weakness, including sickness, deteriorates which is why many do not seek attention until it is too late. Educating African American women on the importance of preventive and medical care is essential.

Regardless of the associated stigma of the African American woman and their “superpower” and that they can do “all things” …

Reducing Stigmatism In Suboxone Users, Jessica S. Lovelace

Doctor of Nursing Practice Projects

Purpose: To assess the impact of an evidence-based educational intervention to decrease provider stigma of patients on buprenorphine for opioid use disorder in a primarily rural primary care setting.

Methods: This quality improvement project used a pre- and post-intervention design to assess knowledge, attitudes, stigma, and confidence to care for patients with opioid use disorder of four providers from four rural health care facilities. The providers completed a survey before and after a 60-minute educational intervention that covered topics such as medication for opioid use disorder, patient-centered communication, and evidence-based prescribing practices for OUD. Providers were also assessed 8 weeks …

Closing The Gaps: Improving Opioid Overdose Prevention In African American Communities Through Education And Community Engagement, Tara Clinding

Doctor of Nursing Practice Projects

African Americans continue to experience high rates of opioid mortality, emphasizing the need for culturally relevant community education and overdose prevention strategies. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate community-based opioid overdose prevention education designed for individuals with substance use disorder, family and friends, and community members. Guided by Betty Neuman’s Model, the education focuses on recognizing opioid overdoses, administering naloxone when indicated, and identifying community treatment and recovery resources. A pre- and post-test design was used to evaluate changes in participants' knowledge and confidence following a structured educational session. …

Every Time The Beat Drops, What Does Your Heart Sing About You? Exploring Black Men’S Cardiac Health, Bianca S. Washington

Doctor of Nursing Practice Projects

The disparities Black men continue to face in rural areas in relation to higher rates of cardiovascular disease, uncontrolled hypertension, and cardiovascular mortality in comparison with other racial groups in the United States continue to be disproportionate. The disparities are influenced by limited access to healthcare, socioeconomic barriers, and structural racism within the health care system. Addressing these issues requires culturally tailored, evidence-based practice interventions that would help restore trust and hopefully engage patients to follow up with primary care providers and to take prescribed medication as directed for cardiovascular disease management. The purpose of this project was to examine …

Central Line-Associated Bloodstream Infections In Patients Diagnosed With A Hematologic Malignancy, Rebecca D. Jennings

Doctor of Nursing Practice Projects

Knowledge of nurse-sensitive indicators such as CLABSI and how they impact patient outcomes is an essential aspect of healthcare today. Hospital-acquired infections increase mortality, increase length of stay in the hospital, and increase financial burden to the patient and facility. The aim of this quality project was to provide targeted education on the impact of central line-associated bloodstream infections. Using a pre- and post-survey design, a convenience sample of staff nurses working in the hematology/oncology units of a large academic hospital participated in an education intervention focused on central line-associated bloodstream infection prevention. Knowledge scores were unaffected by the intervention. …

Implementing A Peer Support Team To Address Workplace Violence: Enhancing Healthcare Worker Well-Being And Retention, Christina Liverman

Doctor of Nursing Practice Projects

Workplace violence is a persistent challenge in healthcare and is associated with decreased psychological well-being, increased emotional distress, burnout, and staff turnover among nurses. Healthcare organizations are increasingly seeking evidence-based interventions to support employees following workplace violence incidents. The purpose of this quality improvement project was to implement and evaluate a peer support program for medical-surgical staff following workplace violence incidents and to examine its effect on perceived psychological well-being.

A nonrandomized pre-test/post-test quality improvement design was implemented on a 38-bed medical-surgical unit in a rural community hospital. Registered nurses, licensed practical nurses, and certified nursing assistants were invited to …

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Succession Planning As A Tool For Nursing Recruitment, Retention, And Resilience, Natalie Kennett

DNP Scholarly Projects

Background: Healthcare is facing a significant nursing shortage. This shortage not only impacts bedside nurses but also nurse leaders. Succession planning is a method for recruiting, retaining, and building resilience among nurse leaders.

Purpose: This quality improvement project applied principles of succession planning, including leadership education, training, and assessment of leadership retention and resilience.

Methods: Two interventions were implemented in this quality improvement project. The first was an assessment of a modification in nursing leadership organizational structure that was made in 2024 with the purpose of improving succession planning. This evaluation was completed with the use of …

Integrating Brief Cognitive Behavioral Therapy Into Telepsychiatry: A Professional Development Model For Pmhnps, Catherine A. Roberts

DNP Scholarly Projects

Background: Mental illnesses remain among the most prevalent health conditions in the United States, affecting approximately 23% or nearly one in five adults in 2025 (Centers for Disease Control and Prevention [CDC], 2025); National Institute of Mental Health [NIMH], 2024a). Despite this high prevalence, only 50.6% of adults living with mental health disorders receive treatment (NIMH, 2024a); although the expansion of telepsychiatry has improved access to mental healthcare, medication-management visits are frequently brief and primarily focused on pharmacotherapy thereby limiting opportunities for delivery of psychotherapeutic interventions. This limitation highlights the need for structured, evidence-based psychotherapeutic approaches that can be …

Looking Beyond Traditional Therapy: The Promising Alternative Of Ketamine-Assisted Treatments In Improving The Quality Of Life Of Veterans, Noa Gutmann

Honors Undergraduate Theses

Posttraumatic stress disorder (PTSD) in United States veterans has a long history of treatment with standard care interventions and therapies. Unfortunately, many modern-day veterans experience treatment resistance and comorbid depressive symptoms that have yet to be resolved. This results in suicidal ideation, hospital readmission, and high treatment dropout rates of care plans. Recent evidence has shown a positive impact of ketamine, and esketamine, therapy on PTSD and depressive symptoms severity. Although, the outcomes and generalizability of this emerging therapy, compared to standard care, are not fully elucidated on. The purpose of this literary review was to further examine the current …

Bridging The Gap: Investigating The Impact Of Adequate Prenatal Care On Adverse Maternal Outcomes Among Black And African American Women, Ciaera Ambroise

Honors Undergraduate Theses

The United States continues to face a maternal health crisis marked by persistent racial disparities, with Black women experiencing pregnancy-related mortality rates three times higher than those of White women. Despite national efforts to expand access to prenatal services, inequities in maternal outcomes remain, indicating that the quality of prenatal care may be as critical as its timing and frequency. The purpose of this thesis is to examine whether adequate prenatal care, compared to inadequate prenatal care, is associated with reduced adverse maternal outcomes among Black and African American women in the United States. Guided by a PICO question, this …

Professional Identity Development Among Nursing Students: The Impact Of Structured Reflective Practice, Abdelmonim El Fadely, Kamal Takhdat, Charaf-Eddine Ahraiba, Rahma Bouali, Sabah Selmaoui, Boujemaa Agorram

Health Professions Education

Purpose This study aimed to assess the impact of a structured reflective practice intervention on the development of professional identity among nursing students. Method A mixed-methods design was adopted. The intervention, based on guided reflective practice, was implemented with a voluntary sample of 58 participants. The evaluation relied on a quasi-experimental quantitative approach using the Macleod Clark Professional Identity Scale, with a comparison group and both pre-test and post-test measurements. A qualitative component was also included to explore the dimensions of the studied concept in greater depth. Results Quantitative findings showed a statistically significant difference between the post-test means (p < 0.001), indicating that the reflective practice intervention had a positive effect on the experimental group compared to the control group. The qualitative results further illuminated students’ reflections, which were organized into ten themes corresponding to the study’s conceptual framework: professional knowledge and skills, values and ethics, the nursing role, leadership, professional self-image, social image of the profession, sense of belonging, identification with role models, theory–practice integration, and career choice. These dimensions provided a comprehensive and nuanced understanding of professional identity, capturing the complexity of the concept. Conclusion These results support the integration of reflective practice as a pedagogical approach to fostering the construction and development of a positive professional identity. Professional identity, as a rich and multidimensional concept, goes beyond the process of professionalization—it represents its ultimate achievement.

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Npd Winner's Circle: Overcoming Imposter Syndrome In New Clinical Specialties, Leanna Ross

Publications 2026-present

No abstract provided.

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

Honors Theses and Capstones

Introduction: Nursing education prepares students to care for patient populations by enhancing knowledge of clinical pathophysiology and applying foundational nursing skills to tailor to the unique care requirements of each patient. When analyzing the nursing course curriculums as guides for what is included in nursing education, it is essential to consider relevant patient populations to ensure adequate representation in lectures. Inclusivity of relevant patient populations within curriculums equips students to encounter a variety of patients in a clinical setting. Perinatal substance use has prevalence in the local community of this university, with 6% of all births in New Hampshire in …

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

An Educational Intervention On Mutual Goal Setting For Hospital Nurses: A Mixed-Methods Study, Teresa Jerofke-Owen, Kristi Opper, Joseph Beiler, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Including patients in mutual goal setting is one mechanism to personalize care delivery and improve patient outcomes.

Objective:

The purpose of this study was to examine the impact of a nurse educational intervention about mutual goal setting on nurse engagement and self-efficacy for goal setting and the nurse/patient experience of goal setting.

Methods:

During this explanatory, sequential mixed-methods study, nurse engagement in goal setting and goal quality was assessed through chart audits 1-month pre-intervention (n = 173) and 1 and 3-months (n = 144, n = 137) post-intervention. Nurse self-efficacy was measured with the Appraisal Inventory Tool. Patient experience …

Beyond Numbers: Bridging Statistical Significance And Clinical Relevance In Healthcare Research, Maharaj Singh, Waheeda Khan, Mehreen Fatima

College of Nursing Faculty Research and Publications

Objective: This study aims to bridge the gap between statistical significance and clinical relevance using rigorous statistical methodologies applied to simulated healthcare data, thereby enhancing the translational value of research outcomes for patient‑centered care. Methods: A synthetic dataset representing 10,000 patients was generated, and descriptive statistics were applied to compare two treatment groups. Binary outcomes were predicted using both a logistic regression model and a neural network. Two‑tailed tests with a significant level of 0.05 were employed, utilizing SAS version 9.4 and IBM SPSS Statistics, Version 29.0 (IBM Corp., Armonk, New York, United States of America). Results: The simulated dataset …

Artificial Intelligence And Mental Health: Promise, Pitfalls And Ethical Priorities, Maharaj Singh

College of Nursing Faculty Research and Publications

Mental health conditions are prevalent across the lifespan, yet workforce shortages, long waiting times, and fragmented systems mean many people never receive timely, evidence‑based care. Artificial intelligence (AI), including machine‑learning classifiers and large language models (LLMs), is being explored to support earlier detection, closer symptom monitoring and scalable psychoeducation. Early studies suggest AI can surface risk signals from language, sleep/activity traces and clinical notes; summarise complex records for clinicians; and deliver structured self‑help at scale. At the same time, safety, bias, privacy and accountability concerns remain salient.

Optimizing Tbi Care: Brain Oxygen Monitoring In Nursing - An Evidence-Based Practice, Alyssa Grisham

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims

This DNP project aims to enhance the care of patients with traumatic brain injury (TBI) by improving nurses’ knowledge, clinical decision-making, and early intervention strategies through the integration of brain oxygenation data into routine neurocritical care assessments. This project seeks to promote personalized patient care, reduce secondary brain injury, and improve neurological outcomes for critically ill adults with TBI by implementing an educational protocol designed to deepen understanding of brain oxygen monitoring.

Background of Problem & Description of Current Practice

TBI remains a leading cause of death and disability worldwide and continues to pose a significant public health burden. …