Digital Commons Network^™

Improving Iv Access Outcomes In Obstetric Care Through A-Diva Scale Utilization And Point-Of-Care Ultrasound, Parth S. Patel, Matthew T. Komorowski

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Obstetric (OB) patients frequently present physiological changes, including edema, obesity, and peripheral vasoconstriction, that increase the risk of difficult intravenous access (DIVA). Multiple IV attempts can delay time-sensitive therapies in obstetric emergencies and increase patient discomfort and provider workload. Research studies have supported the use of the Modified Adult Difficult Intravenous Access (A-DIVA) scale to assess patients for DIVA, and the use of point-of-care ultrasound (POCUS) guided peripheral intravenous access (PIVA). In 2025, a preceding Doctor of Nurse Anesthesia Practice (DNAP) project implemented A-DIVA in the Labor & Delivery (L&D) unit of an OB department and found that 35% of …

Nursing Students' Evaluation Of Primary Health Care Clinical Placements - A Cross-Sectional Study, Debbie Procter, Megan Lee, Debbie Massey, Kylie Mccullough, Karen Strickland

Research outputs 2022 to 2026

Aim: Evaluate quality and satisfaction of nursing students' Primary Health Care clinical placements. Background: There is growing recognition of the need to expand the Primary Health Care nursing workforce, with positive clinical placement experiences considered essential for preparing and inspiring future careers in these settings; however, few graduate nurses choose this career path. Design: A cross-sectional study design using purposive sampling. Participants: Data were sourced from National Placement Evaluation Centre's 2023/2024 dataset using the validated PET–Nursing survey. The tool includes 20 items across two subscales - Clinical Environment and Learning Support, with the final item assessing overall placement satisfaction. Surveys …

Co-Design And Pilot Testing Of A Nurse-Led Gp-Supported Self-Management Intervention For Breast Cancer Survivors With Cardiovascular Diseases: A Study Protocol, Anu Correya, Jing Yu Tan, Xian Liang Liu, Daniel Bressington, Leah East, Tao Wang

Research outputs 2022 to 2026

Background/Objectives: Self-management intervention strategies are recommended to address the needs of breast cancer survivors (BCSs) who have cardiovascular diseases (CVDs). Despite the benefits, these strategies are often suboptimally implemented, resulting in inadequate cardiovascular management among BCS with CVDs. The project aims to develop a nurse-led and GP-supported self-management (NGPS) intervention to reduce cardiovascular risks in BCS with CVDs and evaluate its feasibility and potential effects in primary care settings using the double diamond co-design process and the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions.

Methods: The study will be conducted in two phases. In phase I, …

Staff Education To Improve Lithium Adherence In Bipolar I Disorder Through Staff Education, Queendroline Fundong Nkeh

Walden Dissertations and Doctoral Studies

No abstract provided.

Comparing Intraosseous (Io) Access To Intravenous (Iv) Access, Isabella Ouellette Rn, Charlyn Achola Rn, Catherine Marcoullier Rn

Nurse Residency

In adult patients experiencing cardiac arrest, how does intraosseous access compared to intravenous access affect time to medication administration and return of spontaneous circulation (ROSC) during resuscitation?

Patient Ratio Impact On Patient Safety In The Emergency Department, Erin Griffin Rn, Rhonda Leavitt Rn

Nurse Residency

How does high patient to nurse ratios effect patient outcome and satisfaction compared to lower nurse to patient ratios?

Does Apply Boarder Foam Dressings Decrease Hapi In High-Risk Patients In The Acute Care Setting, Felicia Burton Rn, Kathryn Twombly Rn, Amanda Ring Rn

Nurse Residency

Does applying border foam dressings (i.e.mepilex dressings) to patients at risk for skin breakdown prevent pressure injuries and skin breakdown during a patient's hospital stay?

Inactive Nurses In New Mexico: Insights Into License Lapse And Inactive Reserve Status, Kiyoko Dell Davis

Doctor of Nursing Practice Scholarly Projects

Nursing shortages have varied over the decades, yet persist at local, national, and global levels. Nurses report leaving the workforce for many reasons, including professional environment factors resulting from these shortages, further exacerbating a shrinking workforce and population growth. Recent efforts include recruitment and education incentives and implementation of the New Mexico Board of Nursing (NMBON) Inactive Reserve Licensure option, which allows retiring nurses to maintain a reduced-scope nursing license with fewer barriers. Despite these efforts, questions remain: why are nurses in New Mexico leaving the profession and would this licensure category have impacted retention? The purpose of this project …

Improving Continuity Of Care: Evaluating Universal Nursing Handoff Sheets, Elizabeth Ifeloluwa Sanya

Doctor of Nursing Practice Scholarly Projects

Effective communication during nursing handoffs is essential for safe, patient-centered care, as breakdowns in communication are a leading cause of adverse patient outcomes. At a large academic level I trauma center, inconsistent nursing handoff practices were identified across progressive care units following the COVID-19 pandemic. This variability contributed to incomplete transfer of patient information and was associated with increased patient safety incidents, including delayed wound care, central line dressing lapses, and medication errors involving high-alert therapies. The purpose of this DNP project was to plan, implement, and evaluate the use of  standardized nursing handoff sheet and its impact on continuity …

The Effect Of The Continuous Care Model On Self-Practices And Quality Of Life Among Preeclamptic Women, Amira Ahmed Altweel, Salma Abd-Elatty Moawed, Amr Mahmoud Riad, Shaimaa Hassan Mohamady

Nursing

No abstract provided.

Correlation Between Overthinking And Procrastination Behavior Among Nurses, Mona Hassan Abdelaal

Nursing

ABSTRACT Context: A key challenge in understanding internalizing psychological disorders is identifying the cognitive processes that sustain distress and disrupt effective functioning. Recurrent, hard-to-interrupt thinking patterns may interfere with individuals’ ability to initiate and complete intended tasks. Concurrently, individuals may persistently delay necessary actions despite recognizing their negative consequences, indicating a breakdown between intention and behavior. This pattern of delay appears to be associated with seeking short term emotional relief, reduced consideration of future outcomes, and avoidance of prolonged effort. While these issues have been studied independently, their overlapping mechanisms require further investigation. The potential role of repetitive cognitive processes …

Reducing Emergency Department Boarding Using Pull-Based Throughput Intervention: Quality Improvement Project, Eunice Dundu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Emergency department (ED) boarding increases overcrowding and delays care. A 200-bed acute care hospital in the southeastern United States has a median time from inpatient bed readiness to ED departure that exceeds its hospital benchmarks, resulting in prolonged boarding and delays. Hospital data showed a median bed-ready-to-departure time of 76 minutes, exceeding the target of less than 45 minutes. Workflow analysis identified delays in transport activation, communication, and accountability as major contributors to inefficiency.

Aim of the Project: ED throughput quality improvement project aimed to reduce the median time from when an inpatient bed is marked ready to …

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …

Tailoring Interventions For Patient Safety Protocol: A Strategy To Prevent Inpatient Falls, Yashu Adhikari

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Inpatient falls were a significant safety issue at the project site, substantially affecting patient outcomes and organizational resources. The identified gap was the lack of individualized, patient-centered fall-prevention strategies despite the presence of standard fall-prevention bundles. The baseline fall rate of 6.04 was 20% higher than the national benchmark of three to five falls per 1,000 patient days, indicating a clear need for improvement.

Aim of the Project: The quality improvement (QI) project aimed to improve patient safety by reducing inpatient falls through implementation of the AHRQ Fall Tailoring Interventions for Patient Safety (TIPS) protocol on a …

Utilizing A Multidisciplinary Team Approach To Opioid Stewardship In A Long-Term Acute Care Hospital, Lesley Moore

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

The opioid crisis continues to negatively affect patient safety and healthcare outcomes across the United States. Long-term acute care hospitals (LTACHs) care for medically complex patients who often require prolonged pain management and are at increased risk for opioid-related adverse events. At the project site, a 32-bed LTACH, 72% of reviewed patient charts included an opioid prescription upon admission, exceeding recommended prescribing benchmarks and identifying a gap in opioid stewardship practices. The absence of a standardized opioid stewardship program (OSP) and opioid risk screening process increased the risk of opioid misuse, dependency, and adverse patient outcomes.

Aim of the …

Purposeful Rounds: A Structured Fall Prevention Plan: Final Report, Cincerlyn Lewis

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Falls are the most frequently reported preventable events in hospitalized patients.  Falls in the project unit were increasing, and a gap analysis revealed variation in how nurses assessed fall risk and implemented interventions. Evidence indicated that inconsistent rounding undermined situational awareness and delayed identification of patient needs. This gap highlighted the need for a structured, evidence‑based rounding process to improve consistency and reliability.

Aim of the project: The Purposeful Rounds (PR) project aimed to implement a structured process to improve rounding consistency and staff responsiveness, while reducing fall rates over a 12‑week period.

Review of the Evidence: Evidence-based literature …

Improving Timely Hospice Pain Reassessments Through A Quality Improvement Initiative, Brianna Strong-Mosley

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a hospice care organization, a practice gap was observed in prompt pain reassessment with an onset or increase of pain, as mandated within a 48-hour timeframe by the Centers for Medicare and Medicaid Services (CMS). Baseline data showed that only 40% of eligible patients with a pain score of ≥ 6 received a documented pain reassessment within 48 hours. Overall patient satisfaction with hospice services was 45%.

Aim of the Project: The quality improvement project aimed to enhance pain management by increasing the percentage of eligible hospice patients with a documented pain score of ≥ 6 from a …

The Impact Of Hypertensive Disorders Of Pregnancy On Cognitive Outcomes In Offspring: Systematic Review And Meta-Analysis, Berihun Dachew, Tusa, Getinet Ayano, Kim Betts, Amanuel Gebremedhin, Daniel Rudaizky, Gizachew A. Tessema, Rosa Alati

Research outputs 2022 to 2026

Purpose To synthesis the available research on the association between hypertensive disorders during pregnancy (HDP) and adverse cognitive outcomes in children. Methods PubMed, MEDLINE, Embase, Scopus, CINAHL, and PsycInfo were searched from inception to February 2026 to identify relevant studies. Effect estimates and 95% confidence intervals (CIs) were extracted and pooled using inverse variance–weighted random-effects meta-analysis. Results Thirty-nine observational studies published between 1982 and 2026, covering over 12.5 million mother-offspring pairs, were included in the final analysis. The findings indicate that HDP were associated with a 39% increased risk of Intellectual Disability (ID) (OR = 1.39, 95% CI = 1.30–1.47) …

Digital Teaching In Midwifery Education Since 2021: A Literature Review Of Trends, Technological Advancements And Challenges, Michelle Gray, Kristina Vogel, Annette Bernloehr, Terri Downer, Melanie Welfare, Nicola H. Bauer

Research outputs 2022 to 2026

Aim: To produce an updated synthesis of digital learning and teaching approaches in midwifery education since 2021. Background: Globally, there is an increasing trend towards using digital technologies in midwifery education with little examination of trends, terminology or impact by midwifery academics. Design: A comprehensive literature review. Methods: Ten databases were searched (2021–March 2025) guided by JBI methodology and PRISMA-ScR reporting, resulting in 36 empirical studies focusing on digital technologies used with midwifery students. The review mapped recent technological developments, associated benefits and emerging challenges. Results: Digital innovations were in 15 countries and ranged from immersive virtual reality, augmented and …

Detection And Evaluation Of Biofilm-Producing Clinical Bacterial Isolates By Tcp Method In Karbala-Iraq, Huda Ali Salman Almosawey

Al-Esraa University College Journal for Medical Sciences

Background: A biofilm is a complicated, three-dimensional microbial community that forms at an interface and interacts with its surroundings. To detect the ability of bacteria to form biofilms, the Tissue Culture Plate Method (TCP) is one of the most widely accurate methods and is frequently used with clinical isolates. Objective: This study aims to determine the ability of clinical bacterial isolates to form biofilms using the TCP method and to compare biofilm production between different types of bacteria; to study the relationship between biofilm formation and antibiotic resistance, which helps in understanding the reasons for the failure of some antibiotic …

Epigenetic Regulation Of Immune Responses In Autoimmune Diseases And Cancer: Mechanisms And Therapeutic Implications, Faisal H. Al-Amier, Ammar B. Al-Asadi, Aljuboori M. Nafea, Karar M. Jaleel

Al-Esraa University College Journal for Medical Sciences

Immune tolerance balances immune responses with self-tolerance, a balance that is directive by epigenetic pathways. These mechanisms responsible for gene expression regulation and immune cell activity, and include DNA methylation, histone modifications, and non-coding RNAs. Disruption of mechanisms involved in the autoimmune disorder pathophysiology like systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis through the induction of long term inflammation and breakdown of immune tolerance. In cancer, epigenetic changes allow immune evasion and establish an immunosuppressive tumor microenvironment. Epigenetic markers have been used for diagnosis and prognosis, and epigenetic treatments have the potential to rebalance the immune system and improve …

Socio-Demographic And Clinical Profile Of Diabetic Patients: A Cross-Sectional Study, Ali Kadhim Obyes, Suhair Mohammed Hassoon, Dhakam Mohammed Abbas

Al-Esraa University College Journal for Medical Sciences

Background: Diabetes mellitus is a growing global health crisis, disproportionately affecting low- and middle-income countries. In Iraq, prevalence is estimated at 12–15%, yet comprehensive local data on patient profiles remain scarce. Objectives: To describe the socio-demographic, clinical, nutritional, and laboratory profile of diabetic patients attending a tertiary hospital in Babylon, Iraq. Patients and Methods: A hospital-based cross-sectional study was conducted among 200 adult diabetic patients (type 1 or type 2) admitted to the endocrinology unit of Marjan Teaching Hospital from December 2025 to May 2026. Data were collected via face-to-face interviews, medical records, and laboratory reports. Descriptive statistics (frequencies, percentages, …

Predictors Of Culture-Positive Urinary Tract Infections And Antibiotic Resistance Among Pregnant Females In Al-Hilla City: A Cross-Sectional Study, Zainab Salim Husein, Ishraq Ahmed Chiad, Zeena Jamal Alkhazraji

Al-Esraa University College Journal for Medical Sciences

Background: Urinary tract infection (UTI) is a frequent health problem in women. Patients often present with significant pyuria, and sometimes with no bacterial growth. Objective: The purpose of this study was to investigate the correlations between demographic, clinical, and behavioral factors and urine culture findings and to analyze the antibiotic sensitivity patterns of the isolated uropathogens. Methods: A cross-sectional study was done among pregnant women presenting with elevated pus cells (> 20 cells/HPF). Data on demographic characteristics, pregnancy complications, and hygiene habits were analyzed. Urine culture and comparative antibiotic sensitivity tests were performed for the isolated pathogens (Escherichia coli …

Cleft Lip And Palate: From Genetic Foundations To Psychological Impact – A Multidisciplinary Review, Farah Abdulwahab Al-Saadi, Teeba Fares Hadi, Sura Saleem Albermani

Al-Esraa University College Journal for Medical Sciences

Cleft lip and/or cleft palate consider one of the most known and common congenital disorders of the head causing clear disruption of the normal face structure. Despite being the most seen birth defects, the clefts genetic basis is still not fully comprehended. Clefts have sporadic genetic nature, it can occur duo to rare mutations as part of syndromic disease or it can be isolated, non-syndromic cleft. The contemporary advances in genomic technology have enabled a deeper comprehension of the complex architecture of cleft lip/palate, of these technologies are genome-wide association studies, whole genome sequencing, transcriptome-wide association studies and others. Furthermore, …

Global Trends And Research Landscape Of Metformin And Artificial Intelligence: Bibliometric Analysis, Raya Doraid Mohammed, Alaa Qasim Hayder, Hamza A. Saadallah, Ali Q Saeed, Alice Louis Yousif, Safa M Salim, Noor Mahmood Sultan, Mohammed Ahb. Al-Krdoshi

Al-Esraa University College Journal for Medical Sciences

This bibliometric study examines global research trends and key thematic areas in Artificial Intelligence (AI) applications related to Metformin, especially in diabetes treatment. A total of 227 articles were retrieved from the Science Citation Index Expanded (Web of Science Core Collection) from 2020 to 2024. VOSviewer and CiteSpace were used to analyze publications by year, country, institution, journal, citation impact, and keyword co-occurrence. The United States, Canada, and South Korea contributed over 85% of the output, with leading institutions including the University of California, Los Angeles. Keyword mapping identified ``machine learning,'' ``Metformin,'' and ``Type 2 Diabetes'' as the most influential …

Measure The Sensitivity Of Streptococcus Mutans Against Cds Nanoparticles, Ali Essam Ali, Sara Habeeb Jassim, Abeer Ali Marhoon

Al-Esraa University College Journal for Medical Sciences

Dental caries is the most common disease that poses a threat to human health. As a result, caries prevention is crucial because it is now a major global public health issue. Nowadays, there is more focus on employing nanoscale medication delivery devices to prevent dental cavities. Here, an antibacterial activity of CDs synthesis with allover plant by measuring the turbidity and bacterial colony after the effect of CDs NPs on the one-off gram-positive bacteria streptococcus mutans that cause dental caries. The results showed significant (p < 0.05) concentration of 10, 15, 25 μ g/mL of CDs NPs. Fourier transmission infrared spectroscopy (FT-IR) analysis showed the effect of CDs NPs on the bacterial cell, scanning electron microscopy (SEM) that showed the size, shape and the attachment of Nanoparticles to the bacterial cell wall that support the effect of nanoparticles on bacteria. When compared to chemical and physical procedures, environmentally friendly technologies can produce simple, easy, and affordable nanoparticles. has the capacity to function as antimicrobial agents.

Clinical Interactions Of Celiac Disease And Relationship With Type 1 And Type 2 Diabetes Mellitus, Noor Thair Tahir, Raghda Shams Akram, Aseel Ibrahim Abbas, Sahar Abdul Wahab Alshaban, Fatma Abd Alhamza Obed

Al-Esraa University College Journal for Medical Sciences

Celiac disease is a typical autoimmune ailment that can be brought on by gluten, a protein present in wheat, barley, and rye. It is estimated that one person out of every 100 worldwide has celiac disease, with the majority going untreated. Although it can manifest asymptomatically, celiac disease is typified by a variety of gastrointestinal and extra-intestinal symptoms. The consistency of clinical, serological, and histopathological data is essential for the diagnosis of celiac disease. The diagnosis, nevertheless, is often missed and can be difficult. A higher risk of complications and a negative impact on quality of life are linked to …

Mpox Preparedness And Pandemic Memory: An Exploratory Study Among Young And Highly Educated Populations In Iraq, Israa M. Ali Alameen

Al-Esraa University College Journal for Medical Sciences

No abstract provided.

The Pink Color Of Composite In Esthetic Prosthodontics, Reem Abdulrahim Alobaidy

Al-Esraa University College Journal for Medical Sciences

Studies on the detailing of gingival color used a narrative path. Researches on visual gingival color record had various aims, methods, and measurements. It is difficult to match or even join their scores in a scientifically significative mode. A literature search was implemented in the online databases – PubMed, Science Direct, Medline and Google Scholar with the feedback of that progress in dental materials and technology appear handed concernedly due to their special properties and temple of pink gingival color. The activity between gingival color and the shade of ceramic restorations has never been fully discussed. Purpose of this study …

The Role Of Nanotechnology In Improving The Physical And Mechanical Properties Of Denture Base Material, Rasha Mehdi, Intisar J. Ismail, Ahmed Ali Mohammed

Al-Esraa University College Journal for Medical Sciences

Background: Polymethyl methacrylate (PMMA) is still the most common material used for denture bases but its mechanical and physical properties. The aim of this systematic review was to assess the application of nanotechnology for enhancing physical and mechanical properties of denture base materials. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was performed to identify in vitro experimental studies from 2020 through 2025. The review was conducted according to the PRISMA 2020 statement. Included studies that characterised the mechanical or physical properties of nanoparticle-reinforced denture base materials. Results: Fourteen in vitro experimental studies were eligible for the …