Digital Commons Network^™

Improving Medication And Lifestyle Adherence Through A Standardized Clinical Practice Guideline, Chazemba Shamaila

Walden Dissertations and Doctoral Studies

Medication and lifestyle nonadherence remains a persistent and costly problem within healthcare systems and represents a critical gap in nursing practice. Approximately half of adults prescribed long-term medications do not adhere to recommended regimens, contributing to poor disease control, preventable hospitalizations, increased mortality risk, and substantial healthcare expenditures. These challenges are particularly pronounced in outpatient mental health settings, where symptom burden, cognitive impairment, treatment complexity, and social determinants of health further compromise adherence. Addressing medication and lifestyle nonadherence aligns with nursing priorities related to patient safety, quality improvement, and health equity. This Doctor of Nursing Practice (DNP) project focused on …

Hypothermia Prevention In Major Trauma Patients, Alaina Hostetler

Doctor of Nursing Practice Scholarly Projects

Traumatic injuries present a significant health challenge for providers, often resulting in hypothermia, coagulopathy, and acidosis, referred to as the trauma triad of death. Hypothermia significantly impacts trauma patients' outcomes and exacerbates morbidity and mortality rates, particularly in trauma cases with high injury severity scores who require immediate surgical intervention. Despite the detrimental effects of hypothermia, evidence-based approaches to treating hypothermia in this population are lacking. Traditional warming methods heavily rely on provider preference and can lead to inconsistent care. Rapid, reliable, and effective resuscitation interventions are essential in the immediate care of major trauma patients. The proposed project will …

Predictors Of Filipino Life Satisfaction Using The Revised Filipino Satisfaction With Life Scale, Razel Bacuetes Milo, Patricia Calero, Maria Luisa Ramira, Kathleen Soon, Maria Fontimayor, Cynthia D. Connelly

School of Nursing and Health Science: Faculty Scholarship

Background: 

Mental health stigma serves as a significant barrier to seeking help, often leading to maladaptive coping strategies. Given these complexities, it is essential to validate the Satisfaction With Life Scale Revised (SWLS-R) within the Filipino context to assess its psychometric reliability, cultural relevance, and suitability for evaluating well-being and mental health outcomes among Filipinos.

Objective: 

The aims of this study were to evaluate the psychometric properties of the SWLS-R and describe the relationships and significant predictors of life satisfaction among Filipinos living in the United States.

Methods: 

A purposive sample of Filipino adults, fluent in both English and Filipino, …

Collaboration Between People Admitted To Acute Mental Health Units, Their Family Members And Nurses In The Detection Of Mental State Changes And Recovery: A Qualitative Systematic Review, Karen Foster, Coventry, Yvonne Middlewick, Lindsay Smith, Beverley Ewens

Research outputs 2022 to 2026

Mental health nurses can engage with people with mental health challenges and their families due to their presence on acute mental health units. This presence helps to facilitate recovery-focused care within a physically and emotionally safe environment. Mental health care should be person-centred, individualised, and include wherever possible family and other people in the person's support network. The objective of this systematic review was to explore the existing qualitative literature that describes experiences of collaboration between people with lived experience of mental health challenges, their family members, and nurses in relation to changes in mental state during an admission to …

The Effect Of Midwife-Led Continuous Labor Support Care On Delivery Mode And Timely Initiation Of Breastfeeding In Primigravida Women In Northwest Ethiopia: A Hybrid Type I Implementation Study, Mengstu Melkamu Asaye, Aragaw, Eden Bishaw Taye, Kihinetu Gelaye Wudineh, Sara Bayes

Research outputs 2022 to 2026

Midwife-led continuous labor and childbirth support reduces the episiotomy rate and increases the rates of vaginal delivery and early initiation of breastfeeding. However, no studies have yet been conducted in Ethiopia. This study aimed to evaluate the effect of midwife-led continuous labor and childbirth support. A quasi-experimental study involving 419 primigravida women compared an intervention given by trained midwives at two hospitals to routine at two others. Data were collected from July to December 2024 through interviews and record reviews. The McNemar test was used to compare changes, with a p-value of less than 0.05. Midwife-led continuous labor support increased …

Diva Difficult Intravenous Access Assessment, Aileen M. Romero, Mary Jo Sarver

Articles, Abstracts, and Reports

No abstract provided.

An Evidence-Based Educational Intervention To Enhance Nurses' Knowledge Of Metabolic Syndrome In Residential Care Facilities, Marie Tanyi

Doctor of Nursing Practice Scholarly Projects

The project addresses a critical gap in nursing education by implementing a structured, evidencebased educational intervention led by an Advanced Practice Registered Nurse (APRN) to improve nurses’ knowledge of metabolic syndrome in residential care facilities. The purpose was to determine whether this intervention could significantly enhance nurses’ understanding and management of metabolic syndrome, a complex cluster of disorders present in adult populations. Nine nurses participated in targeted educational sessions focusing on definition, diagnosis, complications, and evidence-based prevention and management strategies. Each participant completed the Metabolic Syndrome Knowledge Scale (MSKS) questionnaire before and after the intervention to assess changes in knowledge. …

Global Trends In Bioterrorism And Biosecurity Research Publications (1997–2025): A Scopus Bibliometric Analysis, Festus Mulakoli, Samuel Gesaka, John Mbataru

School of Nursing & Midwifery, East Africa

Introduction: Bioterrorism and biosecurity preparedness are critical pillars of global public health protection and resilience of health systems worldwide. Although this field has grown over the past few decades, there remains limited clarity on how research efforts have evolved and where critical gaps persist, particularly regarding global collaboration and emerging biological threats. To address this, we conducted a bibliometric analysis to map publication trends, influential contributors, and collaboration networks in bioterrorism and biosecurity from 1997 to 2025. This study analyzed global research output, collaboration, and thematic evolution in bioterrorism and biosecurity and identified gaps relevant to preparedness and policy. …

A Qualitative Socioecological Exploration Of Community Health Promoters’ Barriers And Facilitators In Cardiovascular Disease Prevention In Kenya, Emily Muchina, Maureen Akolo, Rose Maina

School of Nursing & Midwifery, East Africa

Background:

Cardiovascular diseases (CVDs) remain a growing public health challenge in low- and middle-income countries, where there is an upsurge of risk factors. Community health promoters (CHPs) have the potential to play a crucial role in CVD prevention and care to underserved communities in Kenya. However, there are limited studies on their experiences, which are likely shaped by multilevel barriers and facilitators across the individual CHP, the community, relationships with primary health systems, and societal-level policies and structures. This study explored the barriers and facilitators shaping CHPs’ experiences in mitigating CVD in Kenya.

Methods:

A qualitative descriptive study was conducted …

Implementing And Evaluating A Mental Health Education And Mindfulness Program For Police Officers, Patricia Lynn Young

Doctor of Nursing Practice

Background: Police officers are routinely exposed to occupational stress and trauma, contributing to an increased risk of anxiety, depression, substance misuse, and post-traumatic stress disorder (PTSD). Targeted mental health interventions are needed to proactively address their mental health. Purpose: This Doctor of Nursing Practice (DNP) project implemented and evaluated a mental health education and mindfulness program designed to reduce operational stress and increase knowledge and use of departmental mental health resources and mindfulness techniques among police officers. Methods: A pre–post intervention design was used over a 10-week period. Participants (n = 14) completed the Operational Police Stress Questionnaire (PSQ-Op) and …

Evaluation Of The Prevention And Management Of Assaultive Behaviors (Pmab) Training For Outpatient Ambulatory Care Staff, Michaela Bowles

Doctor of Nursing Practice

Background: Workplace violence (WPV) disproportionately affects healthcare workers and harms both staff well-being and the healthcare organization. Despite growing attention to WPV prevention, effective solutions remain limited. The purpose of this project was to evaluate the Prevention and Management of Assaultive Behaviors (PMAB) training in an outpatient ambulatory care setting and to assess staff’s confidence and ability to respond to escalating situations. Methods: A pre/post observational survey using Likert-scale, multiple choice, yes/no questions and narrative responses measured confidence before, immediately after, and 3 to 12 months following PMAB training. A retrospective review of WPV incident reports three months before and …

Mindbodystrong: A Pilot To Address Nursing Burnout & To Promote Wellness, Leilah Hunt

Doctor of Nursing Practice

Background: Nursing burnout rates have increased significantly since the Covid-19 pandemic, not only within the United States but throughout the world. As burnout is multifaceted in nature, identifying and addressing the root cause of burnout has been challenging. One approach to remedy burnout effects is by enhancing wellness through daily practice of healthy habits. Purpose: The purpose of this DNP project was to pilot and evaluate the effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on self-rated anxiety, stress, depressive symptoms, and burnout symptoms in a sample population of nurses at a large psychiatric hospital. This program has …

Measuring Provider Confidence In Using Long-Acting Injectable Antipsychotics In Hospitalized Adults With Schizophrenia Spectrum Disorders, Rachel Mccluskey

Doctor of Nursing Practice

Background: Schizophrenia spectrum disorders are severely disabling conditions requiring ongoing pharmacological management. Rates of medication nonadherence among individuals with schizophrenia spectrum disorder are high and strong evidence exists for the benefits of long-acting injectable antipsychotics (LAI) over oral antipsychotics. Despite this, only 10% of patients in Washington State with schizophrenia spectrum disorders are administered longacting injectable antipsychotics. Purpose: The purpose of this project was to measure change in provider’s confidence in prescribing LAI for hospitalized patients with schizophrenia spectrum disorders following one-on-one motivational information (MI) style informational/discussion sessions coupled with a prescribing reference. Methods: This quality improvement project surveyed provider’s …

Blink & Beat: Pupillometry Response In Autonomic Nervous System Monitoring, Ximena Castillo

2026 Spring Honors Capstones Projects

In the neuroscience intensive care unit (NSICU), nurses rely on advanced monitoring tools to detect neurological deterioration. Two noninvasive measures, heart rate variability (HRV) and pupillary light reflex (PLR), are used to assess autonomic nervous system function; however, it remains unclear whether these indicators provide overlapping or distinct information. The purpose of this observational prospective study is to evaluate the relationship between HRV and quantitative pupillometry measurements to determine whether these noninvasive indicators provide congruent information. Data already collected as routine care from NSICU patients is extracted from the medical record for analysis. Understanding the correlation between HRV and PLR …

Dnp Final Report: An Evidence-Based Project To Decrease Stress In Undergraduate Nursing Students, Elaine Wallace

DNP Final Reports

Stress among undergraduate nursing students is a well-documented concern that negatively affects academic performance, clinical readiness, well-being, and program retention. Stress levels are often heightened before clinical skills check-offs, highlighting the need for practical, evidence-based interventions. This Doctor of Nursing Practice quality improvement project examined whether mindfulness-based mandala coloring could reduce perceived stress in undergraduate nursing students. Using the PICOT framework, the project evaluated whether undergraduate nursing students (P) who participated in mindfulness-based mandala coloring (I), compared with no intervention (C), experienced reduced perceived stress levels (O) over a 12-week implementation period (T).

A comprehensive search of the literature supported …

Gamification And Serious Games In Undergraduate Nursing Education For Disaster Preparedness In The United States, Jacob Fast

Dissertations

Disaster preparedness is a critical component of undergraduate nursing education, yet traditional instructional approaches often inadequately prepare students for the complexity and uncertainty of real-world emergencies. Emerging literature suggests that gamification and serious games may enhance engagement and applied learning; however, limited research has examined their integration within nursing curricula from the perspective of faculty responsible for instructional design. This convergent mixed-methods study investigated the extent of integration, perceived effectiveness, and practical utility of gamification and serious games in undergraduate nursing education for disaster preparedness. Quantitative data were collected through a national survey of faculty teaching in CCNE- and ACEN-accredited …

The Benefits Of Glucagon-Like Peptide 1 Agonists In Adult Women With Polycystic Ovary Syndrome, Bethany A. Johnson

Nursing Capstones

Background: PCOS is the most common endocrinopathy in women of reproductive age, affecting 5-6 million women in the United States. Symptoms include hirsutism, acne, hormone imbalances, menstrual irregularity, obesity, infertility, hypertension, and hyperlipidemia. GLP-1s are being studied for their benefits in women with PCOS.

Purpose: To review the current evidence on the efficacy of GLP-1 receptor agonists in improving symptoms and complications of PCOS.

Methods: This scoping literature review used three databases, including CINAHL Ultimate, PubMed, and ClinicalKey. Inclusion criteria were women 18 and older diagnosed with PCOS and studies that evaluated any type of GLP-1 and their effect on …

Analyzing Pressure Injury Trends Among Hospitalized Older Adults From Tarrant County, Oluwafunto M. Olorundare

2026 Spring Honors Capstones Projects

Pressure injuries occur when skin and underlying tissues are damaged due to unrelieved pressure that reduces blood circulation to the affected area. Hospitalized older adults are vulnerable to pressure injuries due to factors such as limited mobility, physiological changes associated with aging, chronic conditions, and longer hospital stays. Despite multiple studies on the prevalence and incidence of pressure injuries at the national and global levels, there is limited research that analyzes trends among hospitalized older adults at the county level, specifically Tarrant County. This research aims to examine pressure injury trends among hospitalized older adults residing in Tarrant County. Using …

Reducing Humpty Dumpty Syndrome In Pediatric Inpatients, Jeanene Burns

Electronic Theses and Dissertations

The Doctor of Nursing Practice project examined pediatric inpatient falls. The healthcare agency involved in the project identified concerns regarding pediatric inpatient falls. Data were collected on pediatric inpatient falls that occurred on two nursing units at this agency based on the Generalized Risk Assessment for Pediatric Inpatient Falls and the Humpty Dumpty Falls Prevention Scale. Results from the project indicated marginal statistical significance, with approximately a 60% reduction in falls after the implementation of the Humpty Dumpty Falls Prevention Scale. A recommendation for future research is a comparison of the two pediatric fall risk assessment tools after the Humpty …

Dna Methylation Of Slc6a4 And Nr3c1 In Term And Preterm Infants: A Pilot Study Of Nicu-Associated Stress, Kathryn J. Malin, Yvette P. Conley, Aleigha Barry, Rosemary White-Traut

College of Nursing Faculty Research and Publications

Background: Preterm infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU) are often exposed to early-life stress, which may contribute to long-term health consequences. Epigenetic markers, particularly DNA methylation (DNAm) of stress-related genes such as SLC6A4 and NR3C1, have been identified as potential biomarkers of early-life stress. Limited research has compared DNAm patterns between term and preterm infants or examined associations between NICU-related stress and DNAm in preterm populations. Objectives: This pilot study aimed to (1) compare DNAm patterns between preterm and term infants, (2) examine relationships between NICU-related stress and DNAm alterations in preterm infants, and …

Predictors Of Opioid Misuse And Abuse Among Pregnant Women In The Us, Henry Ofori Duah, Diane Von Ah, Ethan Morgan

College of Nursing Faculty Research and Publications

Introduction

Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Methods

Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

Results

The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of …

Implementing Hypertension Guidelines Into Clinical Practice, Misti Michele Mays

Electronic Theses and Dissertations

Hypertension is a complex chronic disease process, and it is essential to educate the patient on the disease process, as well as on all aspects of self-management. It is essential that providers choose an evidence-based guideline by which they will manage their hypertensive patients. In addition, providers must schedule regular follow-up appointments with their patients, along with a wide variety of other multifactorial components in regard to the management of patients diagnosed with hypertension. In addition, providers have a responsibility to stay informed on new approaches to blood pressure management by reviewing the professional literature on a regular basis. Much …

Introducing The Ppco Framework, Children's Health

PPCO Resources & Education

Haven't heard of the PPCO Framework yet? It is a framework developed by nurses for nurses that fits nursing questions when searching for literature to support EBP. 

To learn just a little more, we've created a short cheat sheet, with tips, and some examples, and most importantly - links to the original works.

The Significance Of Vaccine Education In Vaccination Status, Emma Webb

Honors College Theses

In recent years, more of the general population of the United States has become skeptical about vaccines and overall vaccination numbers have declined. Since the Covid-19 pandemic, vaccines have become somewhat of a controversial topic due to varying opinions about the adverse reactions and effectiveness of vaccines. The purpose of this study was to determine if there is a correlation between a person’s overall knowledge of vaccinations and a person’s vaccination status by asking a series of questions about the science used in vaccines and identifying the participant’s vaccination status in regards to influenza and Covid-19. This study also asked …

Examining The Relationship Of Work Stressors And Resilience Among Inpatient Oncology Nurses: A Cross-Sectional Study:, Blanca Melida Vasquez-Clarfield

Theses & Dissertations

Burnout among inpatient oncology nurses remains a concern in a specialty marked by high patient acuity, complex care regimens, emotional intensity, and repeated exposure to suffering and death. Resilience is often discussed as a protective resource in nursing, yet less is known about how personal resilience and work resilience relate to work stress and burnout within inpatient oncology practice. This study examined the relationships among perceived work stress, personal resilience, work resilience, and burnout among registered nurses working in inpatient oncology units. It also explored whether selected nurse characteristics were associated with these variables and how nurses described workplace stressors, …

A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga

Research Collection School of Social Sciences

Who profits from the commodification of care and how does such accumulation occur? Focusing on the case of the nursing care market, this paper shows how professional schools and local hospitals within source nations like the Philippines profit from nurses seeking the credentials to qualify for jobs overseas. While existing studies show how nursing skills are exploited and undervalued, this paper argues that it is the process of skilling itself that allows for the accumulation of profit, regardless of whether nurses leave their origin countries to work abroad. This study reveals how global care economies are tightly linked to local …

Utilizing And Optimizing Forecasting Models For Nursing Demand: A Narrative Review, Kalpana Singh, Liyan Ajit D. Souza, Ananth Nazarene, Amane Mounia, Mahmoud Abdelwahab Khedr, Ahmad Mousa, Rebecca Rejo George, Abdulqadir J. Nahwan

Research outputs 2022 to 2026

Background: Accurately forecasting nursing demand is essential for effective workforce planning in the context of increasing patient volumes and the growing complexity of healthcare systems. Reliable forecasting supports optimal staffing, enhances patient care quality, and reduces operational risks. However, traditional forecasting approaches are increasingly challenged by evolving clinical demands, rising chronic disease burden, and rapid technological advancements. Aim: This narrative review aimed to (1) map existing models used for predicting nursing demand, (2) identify key predictive methodologies, data inputs, and evaluation metrics, and (3) highlight existing gaps and implications for healthcare policy and workforce management. Methods: A comprehensive narrative literature …

Standardized Home Blood Pressure Log Implementation For Patients With Hypertension To Increase Patient Awareness And Clinical Action, Ashley Alcala

Doctoral Dissertations & Projects

Background: Home blood pressure monitoring (HBPM) is recommended for hypertension management, yet primary care clinics often lack standardized workflows for distributing, collecting, and using home blood pressure (BP) data. Inconsistent reporting and limited patient understanding of their own BP trends, such as whether readings are stable, elevated, or unchanged, reduce providers ability to make timely clinical decisions.

Problem: Despite evidence supporting HBPM, patients rarely brought usable BP logs to follow‑up visits, limiting providers ability to assess BP control, identify trends, and make timely medication or care plan adjustments.

Approach: This project used a Plan‑Do‑Study‑Act (PDSA) model to implement a standardized …

Reducing Computed Tomography Delay In A High-Volume Emergency Department, Sarah Ouedraogo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Delays in computed tomography (CT) imaging contribute to prolonged emergency department (ED) length of stay and delayed clinical decision-making. At the project site, baseline data demonstrated an average ASAP CT order-to-scan time of approximately 116 minutes for non-critical ED patients, with CT readiness compliance rates of 0%. Gap analysis identified inconsistent patient preparation and fragmented communication between ED nursing and radiology as key contributors to avoidable delays. PICOT question: In non-emergent emergency department (ED) patients (P), how does the use of a CT readiness checklist by ED nurses (I), compared with no standardized readiness checklist (C), affect patient readiness …

Integrating Artificial Intelligence Into Fnp/Dnp Simulation To Enhance Clinical Competency, Doris K. Gonzales

SACAD: Scholarly Activities

Abstract  

This poster presents a theoretically grounded, AI-integrated simulation program design structured across 3-4 semesters of Family Nurse Practitioner (FNP) and Doctor of Nursing Practice (DNP) education. This program is designed to support the development of clinical judgment and diagnostic reasoning among FNP students. Guided by Tanner’s Clinical Judgment Model and Roy's Adaptive Model as Theoretical Framework. The program addresses identified gaps in differential diagnosis and role transition from Registered Nurse (RN) to FNP practice. A needs assessment informed the development of a semester-sequenced curricular framework integrating AI-supported simulation across four semesters. The proposed design illustrates how progressive simulation experiences …