Digital Commons Network^™

Biological Impact Of Chemical-Based Medications On Human Dna: Mechanisms, Clinical Consequences, And Research Gaps, Israa M. Ali Alameen, Sumayah Mahmood Rafid, Baqer Khaled Hothefa

Al-Esraa University College Journal for Medical Sciences

Background: Not long ago DNA has become the subject of interest for the pharmaceutical companies, that because its proven by medical and scientifical fields, that it’s the fundamental sources of proteins, which is the basic element in the cell, therefore, the interaction between the Drug and the deoxyribonucleic acid (DNA) is very important to therapeutic regimens success but in other side it has a dangerous effect like toxicity, and long-term genomic instability. Objective: The aim of this review is to focus on the different studies which examines the effect of different drug like the chemotherapy, antivirals, antibiotics, and immune-suppressants on …

Psychological Distress And Quality Of Life Among Infertility Couples Undergoing Infertility Treatment In Malaysia, Farrahdilla Hamzah, Zamzaliza Abdul Mulud, Malini Mat Napes, Sarah Abdul Mubarak, Rosliza Shafie

Jurnal Keperawatan Indonesia

Infertility often leads to stress, anxiety, and depression, significantly affecting the quality of life of affected couples. This study explored the sociodemographic and psychological factors influencing the quality of life among infertile couples undergoing in vitro fertilization (IVF) treatment in Malaysia, using a cross-sectional design. A total of 126 infertile couples were purposively sampled from three public hospitals offering IVF treatment. The Depression, Anxiety, and Stress Scale (DASS-21) measured psychological distress levels, while the Fertility Quality of Life (Ferti-QoL) scale assessed fertility-related quality of life. Data collection adhered to strict ethical standards, with confidentiality ensured. Participants provided informed consent and …

Assessing Community Readiness And Benefits Of A Nursing Program: Implications For Healthcare And Education, Mary Anne Frances D. Reyes, Aaron A. Funa, Robert Jamisola, Ma. Joahna D. Perdigon, Jerica D. Latonero

Jurnal Keperawatan Indonesia

In response to recent policy shifts allowing the establishment of new nursing programs in the Philippines, this study assesses the perceived readiness of Sorsogon, a geographically underserved province, to implement a bachelor of science in nursing program. It also explores the anticipated benefits that such a program may offer to students and the local community. A cross-sectional survey of 375 stakeholders, selected through purposive sampling, was conducted using a validated instrument developed through expert consultation. Quantitative data were analyzed using descriptive statistics, while qualitative responses were examined through thematic analysis. The findings reveal widespread support for the proposed program, emphasizing …

Effectiveness Of Intradialytic Resistance Training On Muscle Mass And Strength In Patients On Hemodialysis, Sandra Vasquien, I Ketut Swarjana, A.A.A. Yuliati Darmini, I Nyoman Arya Maha Putra

Jurnal Keperawatan Indonesia

Hemodialysis (HD) patients with chronic kidney disease (CKD) lose muscle mass and strength due to protein energy wasting (PEW). The purpose of this study was to test the effectiveness of intradialytic resistance training (IRT) in increasing muscle mass and strength. It used a pre-experimental, one-group pretest-posttest design. Based on a sample size estimate using G*power software, 33 CKD patients undergoing HD at a private hospital in Bali were included. The patients were selected using purposive sampling. Muscle mass was measured using Bioelectrical Impedance Analysis (BIA), while muscle strength was measured using the Medical Research Council Muscle Scale. The Wilcoxon test …

Enhancing Patient Satisfaction Among Coronary Heart Disease Patients Through Islamic Spiritual Care With Murottal In Nursing Practice, Aris Citra Wisuda, Citra Suraya, Suzanna Suzanna, Muhamad Andika Sasmita Saputra, Manisha Manisha, Hesly Devitasari, Dian Emiliasari, Tukimin Bin Sansuwito

Jurnal Keperawatan Indonesia

Spiritual care is essential in nursing, especially for patients with chronic or palliative conditions such as coronary heart disease. Although medical intervention is crucial, Islamic spiritual therapy using murottal has a significant impact on patient satisfaction. This study aims to evaluate the effectiveness of murottal in enhancing patient satisfaction among individuals with coronary heart disease. A quasi-experimental pretest-posttest design was used with 52 participants at Siti Khadijah Islamic Hospital, Palembang, Indonesia. Total sampling was applied, and data were analyzed using the paired sample t-test. Patient satisfaction was measured using a Likert-scale questionnaire to assess the impact of murottal spiritual care. …

Reducing Emergency Department To Medical Icu Boarding Times: Implementing A Standardized Escalation Protocol At A Large Medical Center Hospital, Taylor A. Robbins-Ethridge

Doctor of Nursing Practice Final Project Abstract

Prolonged emergency department (ED) boarding of critically ill patients awaiting transfer to the medical intensive care unit (MICU) delays access to definitive care and is associated with increased mortality and longer hospital stays. This quality improvement project aimed to reduce ED boarding times for MICU patients by implementing the Bed Ready in 30: Just Say Yes escalation protocol. The Plan–Do–Study–Act (PDSA) framework guided the implementation of a structured escalation process to standardize nurse-to-nurse communication once a MICU bed was marked as ready in the electronic health record. A pre–post observational study was used to evaluate the intervention using electronic health …

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

College of Nursing Faculty Papers & Presentations

Purpose of Review

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

Recent Findings

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

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

Doctor of Nursing Practice Projects

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

From Competence To Confidence: Fostering A Culture Of Certification In Nursing, Derhonda Dossett, Sunni Fleming, Amanda Grantham, Johanna Muller

2025

INNOVATION & LEADERSHIP

Background: Nursing certifications help promote excellence in nursing and support the professional identity of nurses. In an urban academic pediatric hospital system, nursing leaders were tasked with increasing professional nursing certification rates within their departments. One team has excelled in increasing their professional certification rate. The team went from 8 to 35 certified nurses which was a 33.75% increase from July 2022 to July 2025. This has elevated the confidence and knowledge base of the nurses and leaders in the Variable Staffing department. Objectives included increasing knowledge and awareness of professional certification, providing resources available to …

Pediatric Nurses’ Perceptions Of The Quality And Usefulness Of Clinical Summaries: Surgeons Versus Generative Ai, Lindsey Patton, Nikki Marshall

2025

RESEARCH

Purpose: The purpose of this study was to compare the performance of AI-generated summaries and physician-written summaries in the pediatric surgery population from nurses’ perspectives.

Methods: The study occurred at a large, academic-affiliated pediatric healthcare system designated as a Level 1 Children’s Surgery Center. Three clinical nurses independently reviewed and compared AI-generated summaries to physician written summaries for patients admitted to the surgery service line utilizing the validated Physician Documentation Quality Instrument (PDQI-9) tool. The nurse evaluation team met prior to scoring to ensure consistency of interpretation and scoring of PDQI-9 domains.

Results: AI-generated and physician …

Psychopharmacologic Management Of Serious Mental Illness In State Prisons, Clarel Neuvieme

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project focused on developing and evaluating an evidence-based clinical practice guideline (CPG) for the psychopharmacologic management of serious mental illness (SMI) in a state correctional health system. The project explored a critical practice gap: the unavailability of standardized, evidence-based prescribing and monitoring protocols for incarcerated individuals diagnosed with schizophrenia, major depressive disorder with psychotic features, or bipolar disorder. The evidence-based project was structured around the central question: “Will an interprofessional team achieve consensus on updating the clinical practice guideline for psychopharmacologic management of serious mental illness in state prisons, thereby improving consistency and quality …

The National Landscape On Wellness Culture And Well-Being Best Practices In Healthcare Systems And Academic Institutions: Results From The Fourth National Summit On Promoting Clinician Well-Being, Megan Amaya, Bernadette Mazurek-Melnyk, Josh Winn, Jeff Messinger

Journal of Wellness

Introduction: The health of our nation’s healthcare workforce continues to decline. A comprehensive, whole-system, evidence-based approach is key to a successful wellness initiative and is the foundation for culture change. Building a culture of wellness leads to better mental health outcomes, healthier lifestyle behaviors, higher levels of engagement and job satisfaction, improved patient satisfaction and employee retention, and a positive return (ROI) and value on investment (VOI).

Methods: The purpose of this cross-sectional, descriptive, anonymous survey was to assess the organizational wellness culture of participants who attended the National Summit on Promoting Well-being and Resilience in Healthcare Professionals. …

A Quality Attack On Hacs, Chasity Tyree-Lee, Krystan Smith, William Gaines, Samantha Frederick, Kendel Richards

2025

QUALITY IMPROVEMENT

Background: Hospital-acquired conditions (HACs) pose a dual challenge to pediatric organizations, compromising patient safety while creating substantial financial burdens, with a single central line-associated bloodstream infection (CLABSI) costing an estimated $48,108 and delaying discharge (Forrester, 2022; Li, 2024). While prior studies have focused on reducing individual HACs through standardized rounding, our pediatric intensive care unit (PICU) adopted a broader, integrated approach.

Methodology: In 2022, we launched a nursing-led initiative to reduce multiple HACs—catheter-associated urinary tract infections (CAUTI), CLABSI, hospital-acquired pressure injuries (HAPI), and peripheral intravenous catheter infiltration and extravasations (PIVIE)—simultaneously. The program empowered Quality Champions (QCs), …

Planting Seeds Of Success: Cultivating Cpen Certification In Pediatric Emergency Nursing, Shelby Flusche, Johanna Muller

2025

INNOVATION & LEADERSHIP

Background: Children’s Health Plano campus has faced challenges in supporting nurses preparing for the Certified Pediatric Emergency Nurse (CPEN) exam, with limited resources available for study and preparation. To encourage certification, a certification champion was identified to provide leadership and guidance. However, it soon became evident that additional support was needed, as many nurses were unsure how to obtain a test voucher and reported low confidence levels regarding exam success. In fact, 75% of nurses initially rated themselves as neutral to not confident in their ability to pass the CPEN exam, highlighting a significant gap in …

Engaging The Night Shift To Sustain A Healthy Work Environment, Kelsey Walsh, Delaney Dewolf, Annie Tolliver

2025

INNOVATION & LEADERSHIP

Background: Night shift nurses often feel overlooked, leading to disengagement and higher turnover. The common question, “What about for the night shift?” highlights gaps in recognition, communication, and collaboration. In 2024, a large pediatric health system launched a Night Shift Forum (NSF) to improve the work environment for this critical group. Results from the AACN Healthy Work Environment Assessment Tool (HWEAT) showed true collaboration (3.41) and meaningful recognition (3.73) as the lowest-scoring areas. Recent studies show that night-shift nurses consistently report lower scores on healthy work environment domains, while organizations with dedicated night councils demonstrate stronger …

Improving The Use Of Nicom ® In Determining Fluid Status In Icu Patients With Sepsis, Maureen Maloney-Poldek

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

No abstract provided.

Norms For Scaling Up Small And Sick Newborn Care: An Overview Of Reviews, Natalie A. Strobel, Georgia Whisson, Derek Swe, Amy Budrikis, Karen M. Edmond

Research outputs 2022 to 2026

Background: The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) currently have no benchmarks or 'norms' for scaling up small and sick newborn (SSN) service delivery in health facilities in low- and middle-income countries (LMICs). Our objective was to understand which systematic reviews had addressed the following norms in the last five years: number of SSN beds per live births in a district or similar administrative unit (admission beds); space requirements for SSN units, including mother-infant dyads (space); health workforce ratios in SSN units (workforce); and travel time to health facilities with SSN units (travel time). Methods: …

Streamlining Sepsis Care And Enhancing Antibiotic Administration Efficiency Through Emergency Department Staff Nurse Education, Dafina Jamillah Skinner

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening medical emergency that requires rapid identification and treatment. Delays in administering antibiotics are directly associated with increased mortality, longer hospital stays, and higher complication rates. Without intervention, patients faced preventable harm, and the organization risked continued non-compliance with federal quality measures. This Doctor of Nursing Practice (DNP) project implemented a structured educational program for emergency department (ED) nurses to improve knowledge of evidence-based sepsis protocols. The practice-focused question asked: For nurses in the ED, will an educational intervention on sepsis recognition and antibiotic stewardship improve knowledge of timely antibiotic administration and blood culture acquisition? Twenty ED …

Development Of Evidence-Based Clinical Practice Guidelines For Monitoring Diabetic Patients Using Smartphone Technology, Ganiyat Funmilayo Efuntoye

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed and validated an evidence-based clinical practice guideline for implementing smartphone technology to monitor diabetic patients in primary care settings with an 80% threshold. The project addressed a critical gap in standardized guidance for diabetes technology integration, which has resulted in inconsistent adoption and suboptimal patient outcomes. A systematic literature review of four major databases yielded 12 high-quality studies representing all evidence levels (I–V) according to the Johns Hopkins evidence-based practice model. Evidence synthesis revealed strong and compelling evidence with consistent results supporting smartphone technology implementation, including HbA1c improvements of 0.4%–0.8%, sustained patient engagement rates …

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

Walden Dissertations and Doctoral Studies

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

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

MUSC Theses and Dissertations

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

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

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

Staff Education On Understanding Nurse Burnout, Kathlyn Tracy Mcglynn

Walden Dissertations and Doctoral Studies

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

Experiences Of Baccalaureate Prepared Nurses On Their Transition To Novice Faculty Members, Theresa Jade Lombardo

Walden Dissertations and Doctoral Studies

The shortage of qualified nursing faculty in Canada threatens the ability to educate sufficient numbers of nurses to meet healthcare demands. Despite this, limited research explores how baccalaureate-prepared nurses experience the transition into nursing faculty roles. The purpose of this qualitative study, guided by Schoening’s nurse educator transition model, was to explore the experiences of baccalaureate prepared nurses on the transition to novice nurse faculty members teaching in 2-year diploma prepared nursing programs in Northwestern Ontario. Five semi-structured interviews were conducted with baccalaureate-prepared novice nursing faculty members, analyzed, and transcribed using Zoom. Data were coded and analyzed using Saldana’s first …

Staff Education On The Timeliness Of Administration Of Insulin For The Hospitalized Diabetic Patient, Precious C. Abidoye

Walden Dissertations and Doctoral Studies

The problem addressed in this DNP project was the necessity for a nursing staff education program (SEP) focused on the prompt administration of insulin and order management as well as the evaluation of the hospital policy regarding diabetes mellitus in nonpregnant adult patients concerning hypoglycemia/hyperglycemia. Timely administration of insulin in the hospital is essential to maintain blood glucose levels within a permissible range, which greatly reduces the chances of encountering complications related to diabetes. The project questions were: Will there be an alteration in the nursing team members’ understanding of the promptness of insulin administration and the associated policy from …

Reducing Missed Appointments In Mental Health Outpatient Care Using Sms Reminders, James Avoseh

Walden Dissertations and Doctoral Studies

Missed appointments remain a serious problem in mental health outpatient clinics. They break the flow of treatment, waste staff time, and worsen outcomes for patients. In this setting, the practice problem is the lack of an evidence-based system for reminding patients about their visits. This doctor of nursing practice (DNP) project focused on developing and evaluating a clinical practice guideline (CPG) for automated text message (SMS) appointment reminders. The guiding question asked: Can a CPG using SMS reminders help reduce missed appointments in a mental health outpatient setting? A thorough review of CINAHL and PubMed found strong support for this …

Staff Education Workshop Focusing On Enhancing Nurse Knowledge And Adherence To The Time (Tissue, Infection/Inflammation, Moisture, Edge) Framework To Improve The Quality Of Wound Assessment And Care, Ijeoma G. Onyejiji

Walden Dissertations and Doctoral Studies

This staff educational project focused on implementing training on the tissue, infection/inflammation, moisture, edge (TIME) framework to address gaps in nurses’ knowledge and improve adherence to the TIME framework during wound assessment. Current evidence shows inconsistent use of standardized wound assessment among nurses, which can lead to inappropriate treatment, delayed wound healing, increased infection risk, and higher healthcare utilization. This project’s question sought to assess whether implementing a staff education workshop focusing on the TIME framework would enhance nurse knowledge and adherence to the TIME framework. Six nurses participated in the training. Pre/post questionnaires were used to evaluate knowledge before …

Nursing Students As Advocates: Addressing Social Determinants Of Health Through Service-Learning, Rebekah Mullins

Nursing Theses and Dissertations

Advocacy is at the heart of nursing practice, and advocating for the social determinants of health (SDOH) is crucial when providing care to patients from vulnerable populations. Service-learning is a strategy that can be used to teach students advocacy skills. Chapter 2 of this dissertation portfolio presents a concept analysis that explores the definition of advocacy using the Walker and Avant method (2019). The concept analysis informed the development of the case study presented in Chapter 3 and the research study presented in Chapter 4. The portfolio includes original, qualitative research that was guided by the interpretive descriptive method. The …

Staff Education To Reduce The Incidence Of Central Line Infections In The Pediatric Intensive Care Unit, Khldon Hassan Al-Omari

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project aimed to reduce the incidence of central line-associated bloodstream infections (CLABSI) in the Pediatric Intensive Care Unit (PICU) by educating clinical staff on the importance of hand hygiene and bundle compliance. Despite established guidelines, CLABSI remains a significant issue in healthcare, particularly in PICUs, where patients are at higher risk for infections. The practice-focused question guiding the project was: How does staff education on hand hygiene and CLABSI bundle compliance impact the prevention of CLABSI in the PICU? Twenty-five PICU nurses participated in the educational sessions. Analytical strategies included pretests and …