Digital Commons Network^™

Addressing Nursing Student Burnout Through Mindfulness And Zen Den At University Of The Pacific, Jeremy Seaton, Tanairi Ingram, Natalia Zelayandia

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

Background:

Burnout among nursing students is a critical issue that negatively impacts academic performance, mental well-being, and long-term professional retention. Entry-Level Master of Science in Nursing students at University of the Pacific experience heightened stress due to rigorous coursework, clinical demands, and underdeveloped institutional mental health support.

Aim:

This Quality Improvement project aimed to reduce stress and strengthen emotional resilience among nursing students through Mindfulness-Based Stress Reduction education and the creation of a peer-supported wellness space, the “Zen Den.”

Methods:

A pre- and post-intervention design was implemented, utilizing surveys to measure mindfulness knowledge, attitudes toward self-care, and stress awareness. Zen …

Enhancing Pediatric Sun Safety: A Parent-Focused Intervention In El Dorado County, Ashley Riley, Calvin Nauer, Alaina Godwin

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

Background:

Childhood ultraviolet (UV) exposure is the most significant modifiable risk factor for skin cancer, yet proper sun protection remains inconsistently practiced by parents. In El Dorado County, California, where high altitude and intense sun exposure amplify UV risk, knowledge gaps and misinformation persist despite resource availability. This quality improvement (QI) project aimed to strengthen parental knowledge, confidence, and modeling of sun-safe behaviors for their children through an evidence-based community education program.

Aim:
The goal of this QI initiative was to improve parental attitudes, self-efficacy, and photoprotective behaviors by implementing a three-part, nursing-led educational intervention focused on UV risk awareness, …

Perils Of Precisely Equal Group Size In Randomised Controlled Trials, Richard Gray, Daniel Bressington, Bridgina Mackay, Martin Jones, David R. Thompson

Research outputs 2022 to 2026

No abstract provided.

The First Year Of Assisted Dying In New Zealand Through The Lens Of Healthcare Professionals Not Directly Involved In The Process, Waqas Arshad, Aida Dehkhoda, Melissa Carey, David B. Menkes, Nicholas Hoeh, Frederick Sundram, Rosemary Frey, Gary Cheung

Research outputs 2022 to 2026

Background: New Zealand’s End of Life Choice Act 2019 was enacted in 2021, allowing terminally ill people experiencing unbearable suffering to request assisted dying if they are expected to die within six months. Healthcare professionals not directly involved in assisted dying provision may have unique perspectives on implementation, yet this remains under-explored. Methods: This qualitative study was conducted between June and November 2022. We used purposive and snowball sampling to recruit potential participants through various sources, including the Ministry of Health’s assisted dying training and communication email list. A multidisciplinary research team developed a semi-structured interview guide. The individual interviews …

Effect Of Focussing On Anastatica Hierochuntica Flower On Labour Pain, Duration Of Labour And Perceived Fatigue During Labour: Randomized Controlled Study, Emine Koç, Şükran Başgöl, Sümeyye Bal, Sabire Kirtiloğlu

Journal of Asian Midwives (JAM)

Background: Maternal fatigue and pain during labour can adversely affect the health of the mother, fetus, and newborn. Anastatica hierochuntica is a plant traditionally used in some cultures during childbirth rituals. When placed in water, the dried flower gradually unfolds and symbolically represents the opening of the uterus and birth canal. This study aimed to investigate the effect of focusing on the Anastatica hierochuntica flower during labour on labour pain, duration, and perceived fatigue.
Methods: This randomized controlled trial was conducted in the delivery unit of a mother-friendly hospital with 119 participants 60 in control group and 59 in intervention …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

Improving Patient Access To Providers By Optimizing Message Center Workflow, Serena Valino

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement initiative that addressed the practice problem of having large volumes of unanswered messages within the patient portal. To increase patient access to the healthcare provider, a literature search was conducted using the practice-focused question: Can standardization of patient portals improve the message turnaround time? In January 2024, a scoping review of nursing message center pools determined 79 pools lacked standardized names and established workflows for 37 ambulatory clinics. Pool names were identified for each clinic and listed using an Excel spreadsheet. Clinic pool members were isolated, and it was determined by …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Mental Health In Adult Oncology Patients, Jenna Pope

Capstones

Adults with cancer suffer from mental challenges that frequently go under diagnosed and under treated (Fernando et al., 2023). This can lead to lower quality of life, resulting in reduced adherence to treatment, more frequent hospital stays, increased healthcare costs, and increased mortality rates (Matthews et al., 2025). There are currently no policies on mental health screening for adult oncology patients at every outpatient appointment. By consistently utilizing standardized screening tools such as the PHQ-9 and GAD-7 during all oncology appointments, this can close the gap in policy to address mental health needs of these individuals. It is vital to …

Improving Pharmacovigilance Via Systematic Gass Screening And Interdisciplinary Collaboration In The Outpatient Setting, Dustin Bower

Doctor of Nursing Practice Projects

The goal of this Doctor of Nursing Practice (DNP) quality improvement project was to enhance pharmacovigilance practices among non-medical mental health providers (NMMHPs) in an outpatient psychiatric setting. The project addressed the issue of limited recognition and reporting of adverse drug reactions (ADRs) by NMMHPs, which can lead to delays in clinical intervention and compromise patient safety. To tackle this problem, a quasi-experimental, pre–post intervention design was employed. Two evidence-based strategies were implemented: (a) eight weekly collaborative training sessions that focused on identifying, documenting, and communicating ADRs, and (b) the integration of the Glasgow Antipsychotic Side-Effect Scale (GASS) into the …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Quality Improvement Project: Effect Of Multi-Level Student Collaboration On Clinical Judgment In High-Fidelity Simulation, Jillian Carroll

Doctor of Nursing Practice Projects

There is a gap in undergraduate nursing curriculum on incorporating collaboration and communication into patient care, leading to a lack of competence and confidence in novice practice. Using collaboration in high-fidelity simulation, students gain real-world exposure and opportunities to communicate and make independent decisions. Using Kotter’s eight-step change theory, this project addresses the limited exposure to collaboration by implementing purposeful interdisciplinary collaboration within high-fidelity simulation to improve undergraduate nursing students’ confidence and competence in nursing practice. This will build on Patricia Benner’s novice-to-expert theory and help advance Associate Degree Nursing (ADN) students into a safe and effective novice year of …

Quality Improvement Project: Impact Of A Brief Mindfulness-Based Stress Reduction Program For Healthcare Providers Who Evaluate Veterans, Peng Anderson

Doctor of Nursing Practice Projects

Long-term stress can lead to healthcare provider burnout. Mindfulness-based interventions, even when shortened, may provide a promising and innovative method to reduce stress and prevent burnout. Research on mindfulness programs has demonstrated significant benefits for both providers and patients. This quality improvement project aims to evaluate the effect of a brief mindfulness-based stress reduction program (MBSR) for providers who evaluate veterans on the variable of mindfulness awareness compared to current site practice. Lewin’s change management model and Peplau’s Interpersonal Relations Theory were used. Plan-Do-Study-Act was the implementation framework applied. The design was pretest-posttest using the Mindful Attention Awareness Scale (MAAS). …

Parental Experiences With Financial Toxicity In The Pediatric Intensive Care Unit: A Phenomenological Research, Sohrab Alexander Sardual

Dissertations and Theses (Open Access)

Background: Parents of children admitted to the pediatric intensive care unit (PICU) encounter multiple stressors; however, there is a need to further understand their experiences with financial toxicity. Understanding parents’ experiences and perspectives on how they can be assisted is a critical first step to formulating interventions to help parents deal with financial toxicity.

Aims: The aims of this study are (a) to describe the experiences with financial toxicity of parents with critically ill children admitted to the PICU and (b) to explore parents’ perspectives on how they can be assisted in dealing with financial toxicity.

Methods: A phenomenological qualitative …

A Comparison Of Cultural Aspects Of Breastfeeding In The United States Vs Italy, Madison P. Wallace

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Healthcare systems internationally differ from policies, funding and resources available, and it is evident when comparing the United States and Italy. Participation in the Nursing Across the Lifespan study abroad program at the University of Arkansas Rome Center and Tiny Tusk Breastfeeding and Infant Support internship inspired a comparative exploration of breastfeeding practices in the United States versus. Italy. The United States has a mixed public- private insurance system, workplace policies and government assistance, while Italy has a universal healthcare system with a mandated maternal work paid leave to support breastfeeding mothers. Italy's program supports education and physical care needed …

Gender Differences In Psychological Strengths Among Rural Adolescents, Angela Preston, Jodi Bullard, Rachel Smith, Ashlyn Peppler

Nursing Faculty Publications and Presentations

Purpose: Rural adolescents often lack access to mental health care along with increased rates of depression and suicide completion. While psychological strengths have been associated with positive outcomes globally, little is known regarding the prevalence of these indicators (hope, self‐efficacy, resilience, optimism, and gratitude) among adolescents living in rural Texas. The purpose of this study was to describe how rural adolescents report their psychological strengths and examine the data for potential gender differences.

Design and Methods: A secondary analysis of cross‐sectional data was performed on the RStudio platform using tests of central tendency and inferential statistics. Results: There were 425 …

Lived Experiences Of Chemotherapy-Induced Nausea And Vomiting Among Patients Diagnosed With Cancer At Machakos Level Five Hospital, Nancy Njeri Kamau

MSc in Advanced Practice Nursing

Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the most prevalent and distressing adverse effects of cancer treatment, affecting a substantial proportion of patients and significantly compromising their physical functioning, nutritional status, treatment adherence, and overall quality of life. However, there is a paucity of localized evidence on the magnitude and functional burden of CINV among patients diagnosed with cancer receiving chemotherapy at county referral hospitals, such as Machakos Level 5 Hospital, hence the current study.

Aim of the study: The study aimed at exploring the lived experiences of chemotherapy induced nausea and vomiting among patients diagnosed with …

Enhancing Adherence To Veterans Affairs/Department Of Defense And American Psychiatric Association Clinical Guidelines For Alcohol Use Disorder, Corinna M. Trevino

Doctor of Nursing Practice

Alcohol use disorder continues to be significantly undertreated within outpatient behavioral health settings, particularly concerning pharmacological interventions. Despite the presence of robust national clinical guidelines recommending medications such as naltrexone for individuals with moderate to severe dependence, the rates of prescribing these medications remain modest owing to inconsistent screening procedures, limited referral practices, and provider follow-through barriers. This project was implemented at a substance use treatment center in a large metropolitan area to improve adherence to clinical practice guidelines. The purpose of this project was to increase prescribing of naltrexone and improve referral for patients with moderate to severe alcohol …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Metabolic Screening In Veterans On Antipsychotics Mood Stabilizer, Joy Nneka Eke

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was conducted to examine a quality improvement initiative that sought to address metabolic syndrome screening consistency for veterans on antipsychotic medications at a U.S. Department of Veterans Affairs health system located in the Midwest region of the United States. The project centered on whether the quality improvement program assessing compliance with the current metabolic syndrome screening process reflects increased early detection of metabolic syndrome to prevent cardiovascular complications. Data collection involved comprehensive chart reviews of 50 veterans’ records. The data collected were analyzed using a specially designed quality improvement initiative assessment form developed …

Evaluating A Blood Warming Device For Packed Red Blood Cell Transfusions To Decrease Hypothermia In Very Preterm Infants: A Randomised Control Trial Protocol, Kayla C. Everhart Phd, Rn, Michael D. Wirth Msph, Phd, Face, Victor N. Iskersky, Robin B. Dail Phd, Rn, Faan

Publications

Background: This protocol describes a study to test a commercial blood warming device in warming blood transfusions to prevent hypothermia associated with packed red blood cell (PRBC) transfusions in very preterm infants. Objectives: Very preterm infants receiving blood transfusions warmed by a commercial blood warmer will have less central body hypothermia post transfusion (abdominal temperatures < 36.5°C) and/or a higher mean abdominal temperature for the hour after the transfusion is complete compared to those receiving blood transfusions by standard of care. This trial has been registered with Clinicaltrials.gov (trial number NCT05170633). Methods: In this trial, which is funded by The Gerber Foundation and adhered to the SPIRIT2013 checklist, 140 very preterm infants with an order to receive PRBCs will be randomised into a standard of care group to receive one PRBC transfusion over 3 h with blood in a syringe at room temperature or into the intervention group to receive one PRBC transfusion over 3 h using a Hotline® Blood and Fluid Warmer. Abdominal skin temperatures will be measured every minute through a blood transfusion using a skin thermistor and datalogger. Data analysis: Descriptive statistics will be computed for each group to compare demographics and all infant pre-, during, and post-transfusion body temperatures. A student t-test will be used to compare the groups on mean post-transfusion temperatures as a primary outcome variable. To examine thermal change over time between the two groups, linear mixed models with a random intercept will be utilised. Results: This trial began in January 2022, in a South Carolina neonatal intensive care unit and is ongoing. Discussion: This RCT will determine if warming PRBC transfusions will prevent hypothermia in preterm infants during and after blood transfusions. Results from this trial will be used to design national standards for blood transfusions in preterm infants to decrease morbidity and mortality.

The Effect Of Simulation On Nurses’ Confidence With Providing Post-Fetal Death Support To Bereaved Parents, Monique Scholine, Shannon Zalewski, Erin M. Franklin, Sandria Jamieson, Janelle Diaz, Donna Davis, Kristi Vargo, Nicole Adokou, Kettia Antoine, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Fetal death (FD) affects one in 10 women worldwide and is associated with negative sequelae such as complicated grief. The negative effects of FD may potentially be mitigated through provision of bereavement support (BS) by trained healthcare workers.

Purpose: The purpose of this study was to explore the effect of simulation on registered nurses’ (RN) confidence in providing BS following FD.

Methods: This was a quasi-experimental study conducted within a South Florida community hospital. Nurses were recruited via email/flyers. Participation in the study entailed attending a post-FD simulation session, and completion of the Perinatal Bereavement Care Confidence Scale (PBCCS) …

Safety In Stability: A Cdc-Guided Evaluation Of Hospital Fall Prevention Practices, Matthew C. Dougherty

Electronic Theses and Dissertations 2020 - Present

Hospital falls remain a persistent and preventable cause of patient harm, emphasizing the need for continuous evaluation of fall prevention practices. This project assessed the effectiveness of AdventHealth Orlando’s fall prevention policy using the Centers for Disease Control and Prevention (CDC) Program Evaluation Framework. A mixed-methods design incorporated quantitative analysis of 12 months of fall data and qualitative feedback from frontline staff surveys and discussions. Results demonstrated a decrease in total falls from 549 in the previous year to 528 in the current year, indicating early progress despite the incomplete reporting period. Unit-level analysis showed a mean improvement of 16.9% …

Exploring The Lived Experience Of Nursing Faculty In Preparing For The Next Generation Nclex: A Qualitative Study, Mary Granoff, Missilia Gilbert, Marjorie Lima, Erika Nusbaum, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: According to the Nursing Council of State Boards of Nursing (NCSBN), more than half of all errors among new graduate registered nurses are related to a lack of clinical judgment, a critical component of nursing practice. Considering the Next Generation National Council Licensure Examination (NCLEX) focuses on clinical judgment, a greater understanding of faculty’s Next Generation NCLEX (NGN) teaching preparedness is needed. The purpose of this study was to explore nursing faculty’s lived experience preparing students for the NGN.

Methods: This was a qualitative descriptive study. Data were collected via 15-minute individual interviews. Participants were pre-licensure nursing faculty from …

Pilot Testing The Reliability And Validity Of The Modified Obstetric Fall Risk Assessment System, Geraldine F. Lamoglia, Ashley H. Hurtado, Yasmin Solis, Deborah Pol, Natalie Bermudez

Nursing & Health Sciences Research Journal

No abstract provided.

Retrospectively Examining The Probability Of Acute Skin Failure Among Hospitalized Patients With Hospital-Acquired Pressure Injuries, Tori C. Hatch, Jeanine M. Salamone, Pierna F. Vaughner, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Acute skin failure (ASF) in hospitalized patients is a growing concern and a product of multisystem organ failure. Unlike hospital-acquired pressure injuries (HAPIs), ASF is not preventable despite prevention measures. The Skin Failure Clinical Indicator Scale (SFCIS) was recently developed to assess the probability of ASF. The purpose of this study was to retrospectively examine the probability of and factors associated with ASF in hospitalized individuals with HAPIs.

Methods: Data were collected from the electronic health records of in-patients with stage 3 or greater HAPIs over two years. Collection included demographics, comorbidities, COVID status, wound staging, injury location, SFCIS, …

A Descriptive Study Of Non-Pharmacological Interventions In Early Labor In Nulliparous Term Singleton Vertex (Ntsv) Women, Candida R. Bell, Acklin Gordon, Dianna Hill, Elba Rivera, Heather R. Cowherd, Ivette Ramos, Martha Valdes, Maureen Gordon, Silvia Foltan, Silvia Medina, Catherina C. Chang Martinez

Nursing & Health Sciences Research Journal

Introduction: Positional changes may contribute to progression of labor in nulliparous women. We investigated the use of non-invasive, non-pharmacological interventions during the first stage of labor in nulliparous, term, singleton, vertex (NTSV) women at a community hospital in the U.S. Another aim was to compare the times from the first intervention to completion of the first stage of labor across three interventions.

Methods: Ours was a descriptive, retrospective study of 98 NTSV women from January to June 2025. Descriptive and inferential statistics were analyzed using Statistical Package for Social Sciences version 27.

Results: Most women were Hispanic (71%), averaging 31 …

Promoting Healthy Diet Adherence Using A Multisensory Approach For Post-Stroke Patients: A Pilot Randomized Controlled Trial, Stacey Myers, Yuki Asakura Strempek, Sarah Kaster, Clare Hall

Nursing & Health Sciences Research Journal

Introduction: Evidence supports a healthy diet for secondary stroke prevention; however, programs to implement nutrition education remain inconsistent. This study assessed the feasibility and efficacy of using a multisensory approach called the “Hands-on Training” program (HOT) to improve healthy diet adherence among patients rehabilitating after stroke.

Methods: This pilot randomized controlled study was conducted at an inpatient rehabilitation facility. Stroke patients were randomly assigned to either an experimental group who received HOT or a control group who received conventional education. The HOT group received real-time meal choice coaching, a healthy meal preparation experience, and additional written education. The Mediterranean Eating …

Harnessing The Communities Of Resilience And Excellence Framework To Advance Population Health: The Healthy West Kendall Experience, Cristina Brito, Simone Cheong, Stephanie Norling, Michelle Mejia, Sandra R. Mclean, Carlos E. Hernandez, Lourdes Boue, Zuanel Diaz, Javier Hernandez-Lichtl

Nursing & Health Sciences Research Journal

Introduction: Fragmented community efforts often dilute health‐improvement initiatives. The Communities of Resilience and Excellence (C.O.R.E) Guide offers a Baldrige-based systems approach that aligns cross‐sector partners around shared metrics and continuous improvement cycles for collective impact. West Kendall, an unincorporated area of Miami-Dade County with over 340,000 residents, adopted the framework in response to rising chronic disease burden and socioeconomic disparities.

Methods: West Kendall Baptist Hospital served as the backbone organization that aligned multi-sector partners, implemented evidence-based interventions, and tracked community-level outcomes. We conducted a cross-sectional evaluation of the Healthy West Kendall initiative's impact across various regions in Miami-Dade County and …

Evaluating Perceptions Of Clinical Sports Pharmacists: Insights From An Orthopedic Clinic Survey, Brandon K. Welch, Sara Panella, Michael Swartzon, Eli Friedman, Samantha Cossin

Nursing & Health Sciences Research Journal

Introduction: Athletes have unique pharmaceutical needs due to injury risk, supplement use, and anti-doping regulations. Despite this, pharmacists remain underutilized in sports medicine. This quality improvement project evaluated clinician and staff perceptions of clinical sports pharmacists at Baptist Health, a large healthcare system in South Florida.

Methods: A 12-question REDCap survey was distributed to 19 staff and clinicians— including physicians, athletic trainers, and medical assistants—across five Baptist Health Orthopedic and Sports Medicine clinics. Responses were measured using a Likert scale and analyzed using descriptive statistics and thematic analysis.

Results: The survey achieved a 100% response rate. Most participants had over …