Digital Commons Network^™

The Impact Of Customized Alarm Sounds On Reducing Alarm Fatigue In Icu Nurses, Abigail L. Kendrick, Elizabeth G. Dunkum, Carly F. Harris

Student Scholar Showcase

Within hospital care, particularly in intensive care units, alarm fatigue poses a major threat to patient safety. As a result of the constant sound of alarms, nurses become desensitized and overstimulated in the health care setting. Patient safety is threatened by an increased risk of errors in care, which may lead to complications and poor health outcomes. By systematically reviewing various research studies within the time span of 2020-2025 regarding interventions to decrease the relevance of alarm fatigue, research suggests that there are methods that can be applied via numerous approaches. By customizing alarm sounds by severity, it is believed …

Quality Improvement Project Strengthening Faculty Competence: The Impact Of Structured Debriefing Education On Nursing Faculty Confidence And Competency Compared To Current Practice, Sudaneyse Emmanuel

Doctor of Nursing Practice Projects

Nursing education sometimes struggles to prepare faculty to lead effective simulation-based learning and debriefing. Inconsistent debriefing practices can reduce faculty confidence and competency, limiting student reflection and the development of clinical judgment. This quality improvement project examined whether a structured debriefing education program could enhance nursing faculty confidence and competency in simulation debriefing compared with current practice at a technical college. The project used the Jeffries Simulation Theory and Lewin’s Change Theory as guides. The project used a one-group pretest-posttest design by using the C-Scale to measure confidence and the Facilitator Competency Rubric to measure competency among nursing faculty who …

Building Connections For Care: A Practical Guide For Novice Nursing Professional Development Practitioners, Debra Hunt

Student Dissertations

Building Connections for Care is a practical textbook designed to support novice Nursing Professional Development Practitioners (NPDPs) as they transition from expert bedside clinicians to educational leaders within complex healthcare systems. Grounded in the Association for Nursing Professional Development (ANPD) practice model, the book integrates ethical foundations, communication strategies, leadership frameworks, and inquiry methods to build confidence and competence in the NPDP role. Chapters trace a developmental pathway from role transition and Benner’s novice-to-expert model through ethics and just culture, incivility and workplace culture, and communication skills including feedback, SMART goals, SBAR, and professional digital conduct. Subsequent chapters expand NPDP …

When The Caregiver Becomes The Wounded, Gracelin L. Young

ATU Scholars Symposium

Burnout among critical care nurses (CCNs) is a substantial threat to nurse well-being, patient safety, and workforce stability. The aim of this paper is to identify risk factors contributing to burnout in CCNs using evidence-based articles. An organized literature search was conducted using CINAHL with key terms including critical care nurses, burnout, risk factors, compassion fatigue, and work environment. Five recent peer-reviewed studies meeting inclusion criteria were chosen. The results validate that risk for burnout is vastly influenced by emotional exhaustion, chronic workplace stress, high patient acuity, sleep disturbances, compassion fatigue, insufficient support, and organizational strain. Findings suggest that burnout …

Examining Outcomes Of Client Education Interventions To Reduce Caffeine Intake In The College-Age Population, Mackenzie Leonard, Mikayla Evans

James Madison Undergraduate Research Journal (JMURJ)

This scoping review aimed to explore health interventions that address excessive caffeine consumption in college students aged 18–23 years. Excess caffeine intake is associated with a range of health concerns, including neurological, cardiovascular, and behavioral issues, highlighting the need for effective interventions to mitigate its impact on overall wellness. The literature exploring interventions aimed at modifying health behaviors among the college student population is notably limited. Furthermore, there has been a lack of studies replicating interventions aimed at reducing caffeine intake. These gaps suggested the need for further investigation and exploration of reports pertaining to health promotion. The results of …

Associate Degree Nursing Students’ Lived Experiences With Simulation: A Qualitative Phenomenological Study, Jamie O'Connor Florez

Doctoral Dissertations and Projects

This qualitative phenomenological study examined the lived experiences of prelicensure associate degree nursing (ADN) students related to skills acquisition and workplace readiness through simulation-based learning at community colleges in California. Skills acquisition and workplace readiness were defined as students’ perceptions of their ability to competently perform nursing skills and prepare for entry into the healthcare workforce. Guided by Kolb’s experiential learning theory, data were collected from 13 ADN students through questionnaires, semi-structured interviews, and reflective journaling and analyzed using Braun and Clarke’s six-phase thematic analysis.

Three themes emerged: varying emotions from excitement to feeling overwhelmed; experiences of collaboration and unprofessionalism …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Program Evaluation Of A Digital Outreach Initiative For Improving Well-Child Visit Engagement Among Children And Adolescents Aged 3–21 Years, Eseoghene Odhu

Doctoral Dissertations & Projects

Background: Well-child visits are essential to pediatric preventive care because they support immunizations, developmental screening, anticipatory guidance, and early identification of health concerns (Abdus & Selden, 2022; Theunissen et al., 2022). Despite their importance, engagement in recommended visits remains inconsistent across healthcare systems.

Purpose: This program evaluation examined the impact of a digital outreach initiative on well-child visit engagement among children and adolescents within a Midwestern faith-based healthcare organization.

Methods: A pre–post evaluation design was used with de-identified electronic health record data from periods before and after implementation of the initiative. Outcomes included patient enrollment, scheduled visits, completed visits, no-show …

Quality Improvement Project: Educating Nursing Faculty On Animal-Assisted Therapy: Enhancing Knowledge And Confidence To Improve Program Outcomes, Sarah J. Whitwell

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate whether an educational intervention on animal-assisted therapy (AAT) improved nursing faculty perceived knowledge and confidence in using AAT to improve program outcomes. The problem addressed was the limited knowledge and confidence among nursing faculty regarding the use of non-traditional, evidence-based strategies to support student mental health. This project was guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory and used a quasi-experimental, one-group pre–post design. The project was conducted with nursing faculty teaching in a baccalaureate program at a four-year public university in Oklahoma. A 10-item Likert-scale …

Nurse Driven Intervention To Address Cesarean Section Rates, Cavetta Tulloch-Lewis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

Cesarean sections (C-sections) account for approximately one-third of births in the United States and remain the most common inpatient surgical procedure. Primary cesarean sections are a major contributor to rising rates, often leading to repeat cesareans in subsequent pregnancies. While medically necessary C-sections are lifesaving, their overuse in low-risk pregnancies is associated with increased maternal morbidity. Labor dystocia is one of the leading indications for primary cesarean delivery and may be mitigated through evidence-based, nurse-driven interventions such as maternal positioning and peanut ball utilization. Registered nurses are uniquely positioned to influence labor progression and promote vaginal birth through continuous …

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, …

Educating Nurses On Caring For Patients With Intellectual And Developmental Disabilities – An Evidence-Based Practice Project, Amyela Adarlo

Loma Linda University Electronic Theses, Dissertations & Projects

Intellectual and developmental disabilities (IDD) refer to a range of conditions that begin before age 18 and impact physical, cognitive, and socioemotional development. Patients with IDD often experience poorer health outcomes due to healthcare providers’ limited training in effective communication strategies. This evidence-based project aims to evaluate whether educating nurses on effective communication with IDD patients improves nurse self-efficacy and confidence in communication and enhances caregiver perceptions of nursing care.

Early Mental Health Screening In The Gi Patient Population: A Quality Improvement Project, Jacqueline Sagala

Loma Linda University Electronic Theses, Dissertations & Projects

Aims

This quality improvement project aimed to increase awareness and better integrate mental health screening in a GI clinic by educating staff and providers. The project evaluated changes in depression literacy, attitudes toward mental illness assessment, perceived training effectiveness, use of the training in clinical practice, and referrals to the Resiliency Clinic.

Background

Patients with chronic GI disorders commonly experience anxiety and depression, yet mental health concerns are often overlooked in specialty care. Although annual depression screening was already a part of the standard care at the Digestive Disease Center at Loma Linda University Faculty Medical Clinics, staff education and …

Implementing A Noise Reduction Protocol To Reduce Perceived Noise In The Icu – An Evidence-Based Practice Project, Soh Jeon

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims:

This project aims to reduce perceived noise in the ICU and promote a healing environment through a multi-interventional noise-reduction protocol and nursing staff education.

Rationale/Background:

The World Health Organization (WHO) recommends that hospital noise levels remain below 35 decibels during the day and 30 decibels at night. However, ICU noise often exceeds 50-70 decibels. Increased noise levels are primarily caused by conversations, monitoring alarms, and routine care activities, such as cleaning and procedures. These high noise levels directly affect patients’ sleep, which is essential to recovery. Insufficient rest can lead to immunosuppression, prolonged mechanical ventilation, and elevated stress …

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. …

Developing A Pediatric Pain Curriculum For Pediatric Anesthesia Fellows In Sub-Saharan Africa: A Delphi Study, Anisa Bhettay, Rebecca Gray, Romy Parker, Nikki Allorto, Abigail Amponsah, Brian Anderson, Lillian Baranzila, Charles Carapinha, Susan Carolus, O' Brien Kyololo

School of Nursing & Midwifery, East Africa

Background Comprehensive pain management in children requires a specialized skillset, with a limited number of clinicians possessing the level of expertise required to successfully navigate the complexities of holistic care. The emergence of pediatric anesthesia fellowship programs in sub-Saharan Africa presents an opportunity to embed a pediatric pain curriculum for trainees, improving the availability of specialist skill and knowledge in the field. Existing pain curricula fall short in addressing the sociocultural aspects of pediatric pain identified through research as being unique to the African context, and do not include elements of leadership and advocacy training required to navigate the complexities …

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 …

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 …

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 …

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 …

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 …

Optimizing Communication In The Periprocedural Area: Implementing Sbar: A Quality Improvement Project, Autumn Chang

Loma Linda University Electronic Theses, Dissertations & Projects

The primary aim of this project is to improve standardized nurse-to-nurse communication at the electrophysiology lab of a large Los Angeles hospital. By providing nursing education on a unit-specific, structured handoff communication framework (SBAR) and incorporating a procedure-specific handoff form for electrophysiology (EP) across pre-, intra-, and post-procedure units, this project aims to improve nurses’ perceptions of the handoff process and the effectiveness of handoff education across the periprocedural units. The project further aims to assess nursing incorporation of the training four weeks post-education and changes in patient satisfaction related to nursing teamwork and communication.

Scrub Up For Success: Transforming Infection Control In Transplant Patients Through Microlearning Video And Poster – A Quality Improvement Project, Wendy Dio

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Healthcare-associated infections (HAIs) threaten patient safety, affecting about 1 in 25 hospitalized patients. Clostridium difficile infection (CDI) is a significant contributor, impacting both high-risk groups and the general population. Proper hand hygiene is crucial for preventing CDI transmission. In the U.S., hospital-acquired CDI costs over $1.5 billion annually and causes nearly 500,000 cases and I15,000 deaths each year. California reported 3,526 CDI cases in acute care hospitals, with Loma Linda University hospitals accounting for 16 cases, or 23% of their health system's infection rate.

Methodology

Nurses in the 6A West-Transplant Unit received a PowerPoint presentation on when …

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, …

Exploring The Relationship Between Workplace Social Capital, Organizational Commitment, And Intent To Stay Among Clinical Nurses In The Acute Care Setting, Leigh Erin Griffis-Cogan

Theses & Dissertations

Background

The persistent nursing shortage, exacerbated by the COVID-19 pandemic and the subsequent “Great Resignation,” continues to challenge healthcare systems nationwide. High turnover rates among acute care nurses negatively affect patient outcomes, organizational stability, and healthcare costs. Prior research highlights the importance of workplace factors, such as social capital and organizational commitment, in shaping nurses’ intentions to stay in their roles. However, limited studies have examined these relationships collectively within the acute care setting.

Purpose

The purpose of the quantitative cross-sectional study was to examine the relationships between workplace social capital, organizational commitment, and intent to stay among clinical nurses …

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 …

Modeling Early Indicators For Success In An Associate Degree In Nursing Program, Joseph D. Moss

Educational Leadership & Workforce Development Theses & Dissertations

Persistent nursing workforce shortages across the United States have increased the importance of Associate Degree in Nursing (ADN) programs as primary entry points into the profession. Community colleges prepare a substantial portion of the nursing workforce; however, attrition within ADN programs limits the number of graduates entering practice. Understanding factors associated with academic performance and program completion is essential for strengthening nursing education pathways and supporting workforce development. The purpose of this quantitative study was to examine early academic and sociodemographic factors associated with successful completion of an ADN program at a suburban community college.

Guided by Becker’s Human Capital …