Digital Commons Network^™

Evaluating Interprofessional And Cultural Competency: A Community-Mental Health Interprofessional Education Event, Megan A. Whitbeck, Carrie A. Griffiths, William F. Miller, Laura M. Skoronski Chavez, Krisy Elrod, Autumn M. Forgione, Anna L. Grippi, John P. Merchant

Journal of Interprofessional Practice and Collaboration

Purpose: This study examined the effectiveness of a mental health focused interprofessional education (IPE) event, where undergraduate and graduate students from four different healthcare disciplines collaboratively completed a case study activity, that included diversity and mental health components.

Methods: A quasi-experimental, one-group pretest–posttest design was used. Participants included 72 undergraduate and graduate students from nursing, occupational therapy, health administration, and counseling programs at a private university. Students engaged in a structured team-based activity emphasizing communication, collaboration, and cultural responsiveness in a mental health care context. Self-reported measures included the Interprofessional Collaborative Competency Attainment Survey (ICCAS) and the Cultural …

Community Health Fair As Experiential Learning: Interprofessional Faculty And Student Perspectives, Sharon Stevenson, Martha Rojo, Jing Jin, Erickson Feliciano, Margaret Love, Scott Wright

Journal of Interprofessional Practice and Collaboration

Abstract

Background: Traditional, precepted clinical practice sites continue to decline. Community health fairs (CHFs), led by experienced interprofessional faculty, present a valuable opportunity. In addition, CHFs provide students with hands-on experience in real-world settings.

Aim: This study examined the perspectives and clinical experiences of interprofessional faculty and students participating in a CHF.

Methods: This study utilized qualitative and quantitative design. Fourteen participants (seven students, seven faculty) engaged in conversational interviews, and completed a faculty and student survey as well as a demographic survey. Descriptive statistics were used to describe the sample and survey responses, and thematic analysis was used to …

It's (Not) Raining Men: Exploring The Themes Surrounding Low Male Presence In Pediatric Nursing, Marcin Janczak

Honors Projects

Background: Men remain underrepresented in nursing, with an even smaller presence in pediatric nursing. Purpose: To examine pediatric-specific themes that may contribute to the low presence of men in pediatric nursing, and strategies to counteract these potential barriers. Methods: CINAHL Ultimate and Google Scholar were searched for primary research published from 2015 to 2025 related to male nurses, male nursing students, gender bias, pediatric care, and clinical experiences. Findings: Four major themes emerged: gender stereotypes and the feminization of pediatric nursing, sociocultural barriers and gender bias, fear and distrust toward male nurses, and psychological and professional impacts on men in …

Enhancing Hpv Vaccination Engagement And Uptake Among Young Adults Aged 17 To 26 Through A Multilevel, Multicomponent Intervention, Sarah Dianne Girlinghouse

Doctoral Dissertations

Background: Human papillomavirus (HPV) remains one of the most common vaccine-preventable infections, with vaccination rates among young adults aged 17 to 26 remaining below Healthy People 2030 targets. University health settings represent a critical opportunity to improve vaccine uptake. Prior to this quality improvement (QI) initiative, student health services (SHS) at a public university in the southern United States did not routinely offer HPV vaccination, resulting in missed opportunities for prevention. Evidence supports provider recommendation, clinical decision support, and improved access as key drivers of HPV vaccination uptake. Purpose: The purpose of this QI project was to increase HPV vaccination …

Motivation And Leadership Development Among Federal Nurse Leaders, Sarah Davis-Arnold

Walden Dissertations and Doctoral Studies

No abstract provided.

Advance Care Planning In Metastatic Lung Cancer Patients: A Quality Improvement Initiative, Khanh H. Thai

Student Theses

Background: Advance care planning (ACP) is essential in achieving goal-concordant care for patients with metastatic lung cancer (MLC), yet it remains underutilized.

Local problem: Despite its benefits, ACP has been inconsistently integrated into outpatient oncology settings, and a baseline evaluation at the project site revealed that only 11% of patients with MLC had ACP documented in the outpatient care clinic.

Methods: This Quality Improvement initiative implemented a formal, Nurse Practitioner (NP)-led intervention into routine oncology care. Using a quasi-experimental nonrandomized design, 13 eligible patients diagnosed with MLC without prior ACP documentation were enrolled in a four-week study. These participants were …

The Use Of Pressure-Mapping Technology To Decrease Pressure Injury Prevalence, Acadia Morse Bsn, Rn

Nurse Residency

Does the use of pressure-mapping, as compared to a standard repositioning schedule, decrease the rate of pressure injuries in acute care patients at a high risk of skin breakdown?

The Healthcare Transition Experiences Of Emerging Adults With Congenital Adrenal Hyperplasia, Leslie Noojin Pitts

ETDs from 2020-2029

Congenital adrenal hyperplasia (CAH) is a group of disorders characterized by enzyme deficiencies impairing adrenal hormone production and requiring lifelong management. Individuals with CAH experience increased morbidity and mortality due to the underlying condition, steroid exposure, and inadequate preventative care. Despite clinical guidelines recommending a structured healthcare transition (HCT), little is known about the HCT experiences of emerging adults with CAH. Understanding these experiences is critical for identifying practice gaps and developing interventions to improve health outcomes. This qualitative descriptive study explored the HCT experiences, challenges, and outcomes of emerging adults with CAH, as guided by the refined Social Ecological …

Birth Satisfaction, As Measured By The Birth Satisfaction Scale–Revised (Bss-R), And Its Role In Predicting Breastfeeding Duration, Maternal-Infant Attachment, And Postpartum Depression, Molly Parker

University Honors Theses

Birth satisfaction has been consistently associated with improved maternal outcomes such as reduced postpartum depression (PPD), stronger maternal-infant attachment, and longer breastfeeding duration. However, the extent to which birth satisfaction independently predicts these outcomes remains unclear. This study examined whether birth satisfaction, as measured by the Birth Satisfaction Scale–Revised (BSS-R), predicts postpartum depression, maternal-infant attachment, and breastfeeding duration in a longitudinal cohort.

Data were drawn from the Prenatal Environmental And Child Health (PEACH) study. Birth satisfaction was assessed at 12 months postpartum using the BSS-R. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS), maternal-infant attachment using the …

New Graduate Nurses' Experiences Of Leaving The Emergency Department, Gemma John

Walden Dissertations and Doctoral Studies

No abstract provided.

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

Improving Antihypertensive Medication Adherence Through Education And Follow- Up Phone Calls In A Primary Care Setting, Sarah Peterson

Doctor of Nursing Practice Final Manuscripts

Hypertension affects nearly half of adults and significantly increases the risk of stroke and cardiovascular disease; however, poor medication adherence remains a primary barrier to effective blood pressure management. The purpose of this evidence-based practice (EBP) project was to improve antihypertensive medication adherence among adult patients in a primary care setting. Guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care, the project utilized a pre-test/post-test design at a private practice clinic. The sample included adults with a hypertensive diagnosis and active prescriptions. Medication adherence was defined as the Morisky Medication Adherence Scale (MMAS-8) scores, measured before and …

Closing The Gap: Integrating A Standardized Depression Screening In Primary Care, Cyndy Marie Oreas

Doctor of Nursing Practice Final Manuscripts

Objective: The purpose of this evidence-based practice (EBP) project is to implement the routine use of the Patient Health Questionnaire-9 (PHQ-9) screening instrument in the primary care setting to improve early diagnosis, treatment, and referrals to mental health.

Background: Depression is frequently underdiagnosed in primary care despite its significant impact on health outcomes. Inconsistent screening practices and a lack of standardized workflows contribute to missed opportunities for early identification and intervention. Routine PHQ-9 screening has been shown to improve detection and facilitate timely referral to behavioral health services.

Methods: A standardized PHQ-9 screening was implemented for adult patients aged 18 …

Reducing Preoperative Anxiety In Patients Undergoing Gynecologic-Oncology-Related Surgeries, Iman Sean Lavine-Richardson

Doctor of Nursing Practice Final Manuscripts

Elevated levels of preoperative anxiety are associated with adverse effects in the postoperative period. Evidence demonstrates the effectiveness of incorporating multimedia into preoperative education to alleviate preoperative anxiety. This project aims to decrease preoperative anxiety levels and increase satisfaction and feelings of preparedness in patients scheduled to undergo gynecologic-oncology-related procedures through the implementation of an evidence-based practice (EBP) informational video. The San Diego 8A’s EBP model was utilized to guide this project. Data was collected, anonymously, through online questionnaires which included the Anxiety Specific to Surgery Questionnaire (ASSQ) to assess anxiety levels and Likert-scale questions to assess satisfaction and feelings …

Implementation Of Comprehensive Checklist For Opioid Use Disorder Treatment In Primary Care, Sophia R. Madden

Doctor of Nursing Practice Final Manuscripts

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Innovating Adhd Care: A Doctoral Capstone On A Pilot Adult Adhd Diagnostic Clinic Implementation, Fozia Aman

Doctor of Nursing Practice Final Manuscripts

Objective: To evaluate whether an APRN-led pilot Adult ADHD Diagnostic Clinic within a large academic healthcare system in the San Diego area improves timely access to diagnostic evaluation and optimizes care disposition for adults with suspected ADHD.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that interferes with functioning in daily life. It often emerges in childhood and persists into adulthood, affecting approximately 360 million adults globally. Despite its prevalence and associated functional and psychiatric burden, adult ADHD remains underdiagnosed and undertreated due to limited primary care training, stigma, and reduced access to psychiatric services, resulting in delayed …

Sleep Tight: A Sleep Hygiene Bundle For Adults To Improve Sleep Quality In A Skilled Nursing Facility, Meaghan Corbin

Doctor of Nursing Practice Final Manuscripts

Abstract

Nearly two thirds of skilled nursing facility (SNF) residents report poor sleep. Negative consequences of poor sleep are depressed mood, anxiety, pain, cognitive impairment, increased risk for dementia, fatigue, decreased concentration, and lower activity participation. A review of literature has shown that implementation of non-pharmacological sleep interventions can significantly improve sleep quality. The aim to screen SNF residents on current self-reported sleep quality and provide non-pharmacological sleep interventions. The evidence-based project utilized the 8 A’s Model. Using the Pittsburg Sleep Quality Index (PSQI), a resident with a score above 0, received the non-pharmacological sleep hygiene bundle: eye mask, earplugs, …

Improving Transition To Adult Care: Assessing Health Insurance Literacy In Adolescent Patients With Congenital Heart Disease, Kaitlyn V. Mudge

Doctor of Nursing Practice Final Manuscripts

Background: With advances in surgery and medical management, 95% of children with congenital heart disease (CHD) survive into adulthood. Transition to adult care is an intricate process. Up to 60% of adolescents fail to follow through with cardiology care, facing three times the risk of needing emergency services. Only 25% of young adults with CHD knew of the need to change their care to an adult provider and to acquire health insurance as an adult. One barrier to successful transition is a lack of insurance coverage and limited insurance health literacy. Higher insurance literacy is associated with increased utilization …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Assessing Impact Of Heat Waves On Pregnancy And Lactation Amidst Climate Change: A Scoping Review., Susan Anyango, Grace Nakate

School of Nursing & Midwifery, East Africa

Background: The escalation of heat waves, attributed to climate change, represents a global public health concern, with pregnant
and lactating women identified as particularly vulnerable due to Physiological and hormonal changes.

Aim: To review the existing research on the effects of heat waves on pregnancy and lactation, identifying potential health risks and outcomes.

Methods: A structured search across PubMed, Scopus, Web of Science, and Google Scholar was conducted using terms related
to heat waves, pregnancy, lactation, and climate change. Inclusion criteria focused on peer-reviewed empirical
studies in English.

Results: Heat waves are linked to increased risks of preterm labor, low …

Descriptive Qualitative Study Of Nursing Students' Perceptions And Behaviors During Student-Led Class Sessions In Uganda, Proscovia Nakaye, Veronica Nakkonde, Mercy Muwema, Grace Nakate

School of Nursing & Midwifery, East Africa

Introduction: Student-led class sessions are a pedagogical approach where students actively engage in the learning process, influencing content, activities, and pace. This method fosters independent learning, communication skills, and teamwork. While some studies have shown the effectiveness of student-led sessions, nursing students often exhibit challenges, such as inattention and negative attitudes, affecting the quality of learning and patient care. Understanding nursing students' perceptions and behaviors in this context is essential for improving nursing education.

Methods: This descriptive qualitative study aimed to explore nursing students' perceptions and behaviors during student-led class sessions at Uganda Christian University. Sixteen direct-entry nursing students …

Prevalence Of Teenage Pregnancy And Associated Factors Among Adolescent Girls In Bobi Subcounty, Northern Uganda., Grace Auma, Margaret Alioru, Geoffrey Kaujju, Grace Nakate

School of Nursing & Midwifery, East Africa

Methodology: A Cross-sectional study design. A survey was conducted among 4893 married girls aged 15-19 years using quantitative methods. Quantitative data was collected through the structured questionnaire, which was administered, data was collected and entered in EPI-INFO 2020 software, and was cleaned and analyzed using STATA version 15.0. Binary logistic regression was done to examine the factors independently associated with teenage pregnancy. A multistage sampling technique was used.

Results: Our study showed that the prevalence of teenage pregnancy in Bobi Sub-County, Omoro District, is high at 27.5%. Significant Factors contributing to the likelihood of teenage pregnancy included those …

Misconduct Among Nurses And Midwives: A Retrospective Descriptive Study Of Cases Handled At The Uganda Nurses And Midwives Council From 2017 To 2021, Barbara Okiror, Christine Nimwesiga, Patience Muwanguzi, Tom Ngabirano, Mercy Muwema

School of Nursing & Midwifery, East Africa

Background: Media reports on the misconduct of nurses and midwives, including cases of fake credentials, drug theft, and incompetence, are on the rise. However, there are no published studies currently addressing this issue in Uganda. Therefore, to inform effective regulation of the profession, we analysed the misconduct cases involving nurses and midwives reported to the Uganda Nurses and Midwives Council between 2017 and 2021.

Methods: The study retrospectively described misconduct cases received and handled at UNMC from 2017 to 2021 and their outcomes. Following total population sampling, data were extracted from case files and then input into a …

Community-Based Education For Hypertension Management Through Lifestyle Modifications – An Evidence-Based Practice Project, Elizabeth Mkroyan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypertension is a highly prevalent chronic disease and a leading contributor to numerous life-threatening complications, including cardiovascular disease and stroke. Time constraints during routine clinical encounters often limit providers' ability to deliver comprehensive education on nonpharmacologic strategies. Community-based educational programs can help close this gap by teaching people about changes they can make to their lives in safe places like a Church. This evidence-based practice project aims to evaluate whether community-based education on lifestyle modifications can improve self-efficacy, self-care practices and behaviors and have high rates of participant satisfaction with the intervention.

Richmond Agitation-Sedation Scoring Implementation In A Critical Access Hospital, Jasmine A. Hobbs

Doctor of Nursing Practice Scholarly Projects

Mechanically ventilated patients who are boarding in rural emergency departments face an increased risk of inconsistent sedation management due to the lack of standardized protocols and the extended transfer times to higher levels of care. The variability in sedation practices can lead to both under- and over-sedation, which negatively affects patient comfort, safety, and clinical outcomes. Research suggests that sedation protocols incorporating the Richmond Agitation-Sedation Scale (RASS) can shorten mechanical ventilation duration and improve clinical outcomes. The purpose of this project was to evaluate the effectiveness of a targeted educational intervention on improving nursing knowledge and comfort with the RASS …

Parent-Focused Resource And Staff Crisis Tool For Addressing Teen Suicidal Ideation, Maya Ewing, Jasmine Crisan, Delaney Fewel, Brandon Fung, Kaylee Cornejo, Alyssa Arthur, Christine Elayda

Nursing Leadership in Community Engagement Projects

The team of seven Seattle Pacific University nursing students partnered with an agency that functions as a family resource center. The agency provides emergency shelter, mobile outreach, and basic needs to families in King County. The team created an evidence-based solution focused on education for suicide prevention. Additionally, the team identified a gap in available staff clinical resources during emergencies.

Experiences Of First-Generation Immigrant Parents In Caring For Children With Type 1 Diabetes, Nahel Kibreab

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Antihypertensive Medication Adherence Through Patient-Centered Assessment In Rural Primary Care, Tiesha Keoni Mathis

Walden Dissertations and Doctoral Studies

No abstract provided.