Digital Commons Network^™

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 …

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.

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 …

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.

Probiotic Intake Related To Hemoglobin A1c Among U.S. Veterans With Type 2 Diabetes Mellitus, Maryann Martin

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Treatment Adherence Among Young Adults With Mental Health And Substance Use Disorders In An Outpatient Behavioral Health Clinic, Nkechinyere Eririma Nwachukwu

Walden Dissertations and Doctoral Studies

No abstract provided.

An Emotional Intelligence Staff Education Program For Patient-Aligned Care Team (Pact) Members, Linda Rogers

Walden Dissertations and Doctoral Studies

No abstract provided.

Surgical Site Infection Prevention And Education With Breast Reconstruction Patients - An Evidence-Based Practice Project, Monica Gaspard

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Breast cancer is a disease characterized by abnormal cell growth that develops from interactions including genetics, environment, and cellular functions (Taurin & Alkhalifa, 2020). Breast cancer is common in women, and breast reconstruction is a main course of treatment (Taha et al, 2023). One in eight women may have breast cancer in their lifetime (Tedesco & Loerzel, 2020). In the United States, 151,641 breast reconstruction surgeries were reported in 2022 by the American Society of Plastic Surgery (Perez et al., 2024). The infection rate after breast reconstructive surgery can be as high as 25% and occurs within …

Postpartum Depression: A National Crisis Calling For Federal Support, Sarah A. Stallsworth

Doctor of Nursing Practice Final Manuscripts

Postpartum depression (PPD) is the leading cause of maternal mortality in the United States, yet it remains significantly underdiagnosed and undertreated. Despite decades of research illuminating its prevalence and detrimental consequences, federal intervention has been limited.  States retain responsibility to address the issue and possess inconsistent and limited legislation.  The purpose of this paper is to propose adding PPD screening as a National Performance Measure (NPM) within the Title V Maternal and Child (MCH) block grant. MCH is a longstanding and resourceful program that provides states funds to address maternal mental health needs. This proposal suggests leveraging a PPD NPM …

Exploring Clinical Ladder Program Participation Among Operating Room Nurses, Camille Sistoso-Lorenzana

Doctoral Projects

Continuous professional development among nurses is vital, yet not all nurses embark on this career journey. The Clinical Ladder Program (CLP) is a retention strategy among various health institutions to retain talent and improve nurses' satisfaction, but this plan is unappealing or indifferent to some nurses. While the CLP is a motivation tool for nurses to focus on clinical expertise in bedside care (Riley et al., 2009), and resources are available to increase a nurse's chances of successfully advancing the ladder, participation in and perspectives on the CLP remain unknown, especially among operating room nurses. This project is guided by …

Improving Medication Adherence In Mental Health Patients: A Quality Improvement Project, Ryan Oh

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction / Aims

Medication adherence among patients with mental health conditions is essential for quality of life, health outcomes, and longevity (Stewart et al., 2022). This quality-improvement project investigates whether a medication reminder app, supported by healthcare staff, effectively improves adherence and how it influences patients' perceptions of their health management.

Methods

Adult patients (aged 18-80) diagnosed with mental health disorders were identified at Orange County Health and Psychology Associates (OCHPA) in February 2026. All patients completed a PAM-10 survey both before and after the intervention, a mobile app called MyTherapy. Clinic staff received training on using MyTherapy to assist …

Implementing Cbt-I Coach App Education During Initial Psychiatric Evaluations At The Va Pec: A Provider-Facing Quality Improvement Initiative, Sarah J. Kang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project aims to increase provider implementation of gold standard insomnia treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), by integrating CBT-I Coach app education into initial psychiatric evaluations within a VA psychiatric emergency clinic (PEC).

Background: Insomnia is highly prevalent among veterans and commonly co-occurs with PTSD, depression, and anxiety. National guidelines from the VA, DoD, and American Academy of Sleep Medicine endorse CBT-I as first-line treatment. Despite this, pharmacotherapy is the dominating intervention in psychiatric emergency settings. The CBT-I Coach app offers evidence-based CBT-I as a free, VA-developed digital tool, but it remains underutilized in acute …

Intimate Partner Violence Screening And Awareness Pilot Project, Eleasha P. Partner

Doctor of Nursing Practice (DNP) Projects

Background: In the United States, one in four women experiences intimate partner violence (IPV), highlighting the critical need for improved screening and intervention within the healthcare system. Routine visits in healthcare settings present a significant opportunity for healthcare providers to identify and address IPV.

Local Problem: A primary care family practice clinic in San Leandro, California , currently lacks a standardized evidence-based screening toolkit for IPV.  The absence of such a toolkit creates a gap in practice, leaving patients at risk of undiagnosed IPV and its related consequences.  To address this gap, there is a pressing need for the development …

Advancing School-Based Sexual Reproductive Health Education Through A Fifth-Grade Educator Toolkit, Emira Romero

Doctor of Nursing Practice (DNP) Projects

Background: Although sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion, educators remain underprepared to deliver this education. Local Problem: A gap analysis conducted at School A, a public elementary school in the San Francisco Bay Area, revealed the absence of a SRH curriculum for their fifth graders. Methods: A Doctor of Nursing Practice (DNP) student-led quality improvement project to introduce a SRH educator toolkit to increase educator confidence and self-efficacy was conducted at School A among fifth grade teachers. Pre- and post-intervention data were collected on implementation day to evaluate the …

Standardizing Preoperative Screening: A Color-Coded Triage Tool Quality Improvement Project, Lyn Green

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Ambulatory surgery centers (ASCs) require effective preoperative screening to ensure appropriate patient selection and minimize day-of-surgery (DOS) cancellations, which affect patient safety, operational efficiency, and financial performance.

Local Problem: In a Northern California ASC serving a racially diverse, predominantly older-adult population with a high burden of chronic diseases, the DOS cancellation rate was 3.84%, exceeding the 2.3% institutional benchmark. Inconsistent preoperative screening contributed to avoidable cancellations.

Methods: A pre- and post-intervention quality improvement design evaluated the effect of a standardized screening tool and staff education on DOS cancellations.

Interventions: The Preoperative Stoplight Tool, a color-coded triage system classifying …

Staff Education To Standardize Suicide Risk Assessment Across All Patients, Ebiere Erukanure

Walden Dissertations and Doctoral Studies

No abstract provided.

Evaluating The Effect Of Implicit Bias Training On Healthcare Staff In An Outpatient Mental Health Clinic, Mah Awoh

Walden Dissertations and Doctoral Studies

No abstract provided.

Evidence-Based Approaches To Managing Adolescent Aggression, April Dade

Walden Dissertations and Doctoral Studies

No abstract provided.

Teaching Motivational Interviewing Techniques To Nursing Staff To Improve Glycemic Control In Patients With Diabetes, Augustine Ngouondjyou Fotsing

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving A1c Levels Through An Individualized Diabetes Education Among Patients Living With Type 2 Diabetes, David W. Cardona Jr.

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) represents an increasing global health, social, and financial burdens. Nutrition, among other diabetes self-management topics, is a foundational aspect in managing T2DM. Significant knowledge gaps persist among patients regarding the impact of mindful eating habits in relation to euglycemia. Individualized diabetes education focused on healthy eating habits offers a promising strategy to address this gap. The quality improvement (QI) project aimed to evaluate the impact of diabetes education, focused on nutritional awareness, and mindful eating habits on hemoglobin (A1c) levels, weight, and diabetes self-management questionnaire scores (DSMQ-R) were assessed among adults living with T2DM. The …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

Improving Staff Competence In Phq-9 Administration, Obinna C. Okonkwo

Walden Dissertations and Doctoral Studies

No abstract provided.

Implementing Trauma Informed Care Practices In An Inpatient Psychiatric Unit, Clara Eyra Dedzo Amenuvor

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education Introducing Music Therapy For Older Adults With Depression, Yvette Negnemboh Takwe

Walden Dissertations and Doctoral Studies

No abstract provided.