Digital Commons Network^™

Self-Stigma Of Seeking Help, Psychological Safety, And Employee Assistance Program Use In Nurses, Latisha Lenee Marshall

Walden Dissertations and Doctoral Studies

Employee assistance programs (EAPs) remain underutilized across various U.S. work sectors, including nursing. There are several barriers that impede nurses from using EAP services, including self-stigma of seeking help (SSOSH) and psychological safety (PS). The purposes of this study, which used the health promotion model as its theoretical framework, were to determine (a) if there was a difference in the level of SSOSH in nurses who have used EAPs and those who have not used EAPs, (b) if there was a difference in the level of PS in nurses who have used EAPs and nurses who have not used EAPs, …

Exploring The Relationship Among Nurse-Specific Factors And Triage Accuracy In The Emergency Setting, Krisada Suamchaiyaphum

ETDs from 2020-2029

Triage is a critical function of emergency nursing practice, directly influencing patient safety, flow, and outcomes in the emergency department (ED). Despite widespread use of standardized triage training and resources, triage accuracy among ED nurses remains suboptimal. The purpose of this three-manuscript dissertation was to examine factors associated with triage accuracy in the ED setting. Manuscript One was an integrative literature review of 14 studies published between 2011 and 2021, with reported triage accuracy rates ranging from 59.3% to 82%. Primary factors associated with triage accuracy were: nurse-specific, patient, and work environment factors. Manuscript Two reported a retrospective study of …

Bridging The Gap Transition From Pediatric Care To Adult Care, Jordan Garcia, Haley Henry, Amina Jamma, Guiliana Jimenez Carrion, Alexis Lowary, Jenna Potts, Josie Ramirez, Iman Siraj

2025

No abstract provided.

Nature-Based Approaches To Dementia, Cognitive Impairment, And Caregiver Well-Being: A Scoping Review Of Gardening And Therapeutic Strategies, Mary Dioise Ramos, Marcy Purnell, Jolie Harris, Gloria Giarratano

School of Nursing Faculty Publications

Background: Dementia is a growing global health concern, with behavioral and psychological symptoms (BPSD) contributing significantly to diminished quality of life and caregiver burden. Non-pharmacological interventions, such as gardening and nature-based therapies, are increasingly recognized for their therapeutic potential. Objectives: This scoping review aimed to: (1) map existing evidence on gardening and garden-based interventions for individuals with dementia; (2) assess impacts on caregivers; (3) identify mechanisms of benefit; and (4) summarize effective design and implementation strategies. Methods: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five databases. Studies were screened using Covidence. Inclusion criteria …

Staff Education To Address Workplace Violence Against Staff, Julie Ann Childers

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) project, the primary focus was on addressing knowledge of workplace bullying within the hospital setting. The project involved developing and implementing an educational program to raise awareness, prevent workplace bullying, and effectively respond to it among healthcare staff. Workplace bullying harms physical and emotional well-being, reduces productivity, increases absenteeism, and increases turnover. The practice-focused question was as follows: In a hospital setting, does implementing a workplace violence (WPV) prevention education program for healthcare workers lead to increased knowledge of WPV incidents, awareness, and management among staff? Using evidence-based strategies and resources, the DNP …

Need For A Psychiatric Facility To Develop A Clinical Practice Guideline On Self-Care To Give To Patients Upon Discharge, Judith Agwu

Walden Dissertations and Doctoral Studies

The project is a Doctor of Nursing Practice (DNP) clinical practice guideline (CPG) on the need for a psychiatric facility to develop a CPG on self-care to give to patients upon discharge. The practice problem was a healthcare facility did not have guidelines to educate patients on self-care upon discharge. Addressing the problem within nursing practice can promote self-care practices and improve overall health outcomes for patients with mental illnesses. The practice-focused question that guided this project was: will a CPG potentially increase self-care among discharged patients? The purpose of the study was to develop a CPG on self-care for …

Faculty Perceptions Of Student Use Of Critical Thinking And Clinical Judgment In Prelicensure Alternative Pediatric Clinical Education, Vanessa Lee Lugo

Walden Dissertations and Doctoral Studies

Both the changing healthcare environment and diverse pediatric care needs highlight the importance of exploring nontraditional clinical placements for entry-level pediatric nursing students to assess their critical thinking (CT) and clinical judgment (CJ). Many graduates are unprepared for pediatric care, creating safety risks and gaps in meeting children’s healthcare needs. The purpose of this study, guided by communities of practice theory, was to explore faculty experiences with and perceptions of CT and CJ use at alternative pediatric clinical sites for prelicensure undergraduate students in the Northeastern United States. Eleven nursing faculty with recent experience working in nontraditional pediatric sites and …

The Effects Of A Nurse-Led Peace Program On Perceived Peaceful End-Of-Life And Quality Of Life Among Head And Neck Cancer Patients Undergoing Concurrent Chemoradiation, Sirinya Pimvichai, Yaowarat Matchim, Tanadej Sinthusake, Kiratiya Wongkalasin

Journal of Health Research

Background: Evidence indicates that peaceful end-of-life care programs benefit terminally ill patients, with nurses playing a central role in program delivery. However, no structured end-of-life care programs currently exist for patients with head and neck cancer (HNC), who often experience profound physical and psychological distress. A nurse-led Peaceful End-of-Life Care (PEACE) program was therefore developed. This study aimed to evaluate the effects of the PEACE program on perceived peaceful end-of-life (PEOL) and quality of life (QoL) among HNC patients undergoing concurrent chemoradiotherapy (CCRT).

Methods: A quasi-experimental, two-group time-series design was conducted with 64 HNC patients recruited from oncology wards at …

“It Seems Like A Never-Ending Job”: Voices Of Female Caregivers Of Older Adults In The Rural Communities, Lalani Nasreen, Bhagyashree Katare, Evans Appiah Osei, Siqi Yang, Sampada Wagle, Julian L. Gallegos, Abidemi Mary Ajuwon

School of Nursing Faculty Publications

Background: Rural female caregivers of older adults face significant caregiving challenges that puts them at high risk for poor self-care and wellbeing. Limited studies have examined the self-care needs of caregivers from a gender equity and social perspective.

Objective: Our study aims to explore the self-care needs and preferences of rural female caregivers and underlying key processes contributing toward their health and well-being. Methods: A qualitative descriptive design was used for the study. A purposive sample of (n = 20) rural female caregivers was obtained. In-depth individual interviews were conducted for data collection. Each interview was about 45- 60 min …

The Relationship Between The Health Science Reasoning Test And Successful Completion Of An Associate Degree Nursing Program: A Retrospective Predictive Study, Joyce A.Ajkuce Kucerovy

Doctoral Dissertations and Projects

The purpose of this study was to retrospectively identify whether the addition of an entrance exam such as the Health Science Reasoning Test (HSRT) to the current admission criteria of an associate degree nursing (ADN) education program would aid in selecting students with the highest chance of successfully completing the program and entering the workforce. A nonexperimental, retrospective, quantitative, predictive correlational study design was used. A retrospective convenience sample of 320 first-year nursing students in an ADN education program was obtained. The G* power analysis showed a minimum sample size of 107 students was needed. Statistical analysis involved a multiple …

Treatment For Women With Mental Health Disorders Associated With Reproductive Health: An Opportunity For Interprofessional Collaboration, Ellen Modlin Phd, Otr/L, Bcp, Caps, Deana Goldin Phd, Dnp, Arnp, Fnp-Bc, Pmhnp-Bc

Journal of Interprofessional Practice and Collaboration

Abstract

Purpose: This article proposes an opportunity for interprofessional collaboration between mental health practitioners (MHPs) and occupational therapy practitioners (OTPs) for the treatment of women experiencing mental health disorders (MHDs) associated with reproductive health (RH) changes throughout the lifespan. This collaborative approach have the potential to optimize women’s health care and mitigate the risk of fragmented care, as these conditions are highly complex.

Method: Peer- reviewed literature from mental health and occupational therapy (OT) research was reviewed and summarized. The search focused on the barriers and potential opportunities for collaboration between MHPs and OTPs in women affected with MHDs associated …

Enhancing Anxiety Identification In Adult Patients, Wonda Crump

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing (DNP) project, I focused on implementing a staff education program for anxiety screening at a health and wellness clinic. Mental health conditions, particularly anxiety disorders, are common in primary care settings. Research shows that anxiety affects millions of adults, yet many cases remain undiagnosed. The practice problem that I identified was that many patients with anxiety disorders were going undiagnosed during regular clinic visits. The clinic had no standard process for screening anxiety, and staff members had a knowledge deficit on the proper use of anxiety assessment tools. This gap in practice led to missed …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

Staff Education Project For Nursing Staff At An Adult Mental Health Clinic To Address Inconsistencies And Inadequacies In Suicide Risk Screening, Grace Oluwasade Awodele

Walden Dissertations and Doctoral Studies

This staff education initiative was designed for nursing personnel at an adult mental health clinic, aiming to address inconsistencies and inadequacies in suicide risk screening practices among health care providers. Despite regular patient interactions, staff frequently lack the necessary knowledge, confidence, and standardized tools to identify individuals at risk for suicide, leading to missed opportunities for early intervention. The existing gap in practice jeopardized patient safety, led to preventable harm, and highlighted the need for evidence-based screening protocols, such as the Ask Suicide-Screening Questions (ASQ) tool, to facilitate timely, equitable, and effective suicide prevention in nursing practice. The project focused …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Prevalence Of Sexual Harassment Among Nurses And Nursing Students In A Culturally Conservative Country, Hanadi Mohamad Nur Steitiyeh, Fatin Ahmad Safa, Jana Daoud Al Hajj Daoud, Adam Tarek Ikkawi, Sahed Ali Fawaz, Hiba Deek

BAU Journal - Science and Technology

The prevalence of sexual harassment among nurses and nursing students in Lebanon is an unidentified social concern. This study aims to identify this prevalence and assess the related factors. Using a self-administered questionnaire the sociodemographic characteristics, workplace variables, physical appearance, and the Sexual Experience Questionnaire (SEQ) were assessed, the data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A total of 380 participated with 71.8% being female and 63.9% aged between 18 and 25. Sexual harassment was experienced by 91 participants (23.9%) and occurred mainly in the patients’ rooms and during procedures. Policies were absent or …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

The Impact Of Nurse-Led Distraction Techniques On Pain And Anxiety During Cancer Treatment In Pediatric Oncology Patients: Examining Virtual Reality And Play Therapy, Alexis Abalos

Nursing | Senior Theses

Children undergoing cancer treatment often experience pain and anxiety during cancer treatment, including chemotherapeutic invasive procedures such as frequent port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce levels of pain and anxiety in pediatric oncology patients. This thesis analyzes existing data through a close examination of primary and secondary research articles that prove the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. Using the University of California, San Francisco (UCSF) Symptom Management Theory, …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

How Instructor Engagement Shapes Nursing Students’ Perceptions And Specialty Preference, Marissa M. Sigel

Nursing | Senior Theses

Background: As nursing students approach graduation, choosing a specialty becomes a key decision. Although clinical rotations offer exposure to different practice areas, the role of the clinical instructor is equally influential. Instructor engagement extends beyond teaching skills and may shape how students perceive clinical environments. Objective: This study examines how clinical instructor engagement influences senior nursing students’ specialty preferences. Method: A longitudinal cohort design will be used with pre-licensure BSN students at a small private university in Northern California. Students will complete the same survey twice during their program, and paired t-tests will be used to assess changes in specialty …

The Relationship Between Registered Nurse Burnout, Organizational Engagement, And Quality Outcomes In Acute Care Hospitals, James E. Parsons

Theses, Dissertations and Capstones

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care …

Routine Guided Meditation In Nicu Nurses: A Coping Strategy For Nicu Nurses Dealing With Newborn Deaths, Gianna Wong

Nursing | Student Research Posters

Purpose: This research study aims to investigate the emotional impact of newborn deaths on Neonatal Intensive Care Unit (NICU) nurses in addition to evaluating their perceptions of routine guided meditation as an effective coping mechanism to manage professional grief and enhance psychological well-being. Methods: Utilizing an exploratory descriptive research design grounded in Pender’s Health Promotion Model (HPM), this study examines the lived experiences and health-promoting behaviors of neonatal nurses following newborn deaths. Data: Anticipatory collection of data will be from a sample of NICU nurses based in California through a twelve-question survey featuring open-ended questions. Qualitative content …

Differences In Comorbidities, Presenting Symptoms, Demographics, And Patient Reported Outcomes In Long Covid By Initial Test Status, Stephanie Georgoudiou

Nursing Dissertations - Archive

Importance Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), remains a major global health concern. Recovery may result in persistent symptoms known as post-acute sequelae of SARS-CoV-2 (PASC), or long COVID. Most studies focus on individuals with laboratory-confirmed infection; however, some patients with COVID-like illness and negative tests also develop persistent symptoms. Testing status should not delay appropriate interventions or specialist referrals. Early, symptom-based care is essential to improve outcomes.

Objective To compare patient-reported outcomes and demographics between long COVID patients who tested positive versus negative during their initial illness.

Design, Setting, and Participants This secondary …

Music Interventions For Critically Ill Patients: Evaluating Effects Of Music On Psychoemotional Symptoms In Critically Ill Patients Receiving Respiratory Support, Allyson Crighton

Honors Undergraduate Theses

Critically ill adults receiving respiratory support in intensive care units (ICUs) frequently experience psychoemotional disturbances such as agitation, anxiety, and delirium, which contribute to prolonged ventilation, increased sedative use, and adverse patient outcomes. While pharmacologic management remains standard practice, associated risks including oversedation and delirium highlight the need for safe, complementary interventions. Emerging evidence suggests that music-based interventions may offer a non-invasive, cost-effective strategy to reduce psychological or emotional distress in this vulnerable population. This integrative literature review examined the effects of music interventions, including passive music listening and structured music therapy, on agitation and related psychoemotional outcomes in critically …

Parenting Stress And Its Association With Parental Technoference: An Integrative Literature Review, Emily S. Machuca

Honors Undergraduate Theses

Introduction: Today, digital devices are a part of daily life, but can serve as a distraction that interrupts important relationships, a process referred to as technoference. In the context of parenting, device use during child interactions may reduce parental attentiveness and engagement, with potential implications for child development and behavior. Parenting stress may influence how and why parents engage with digital devices in the presence of their children. However, the association between parenting stress and parental technoference remains unclear in the current literature. This integrative literature review aimed to synthesize existing evidence examining the relationship between parenting stress and parental …

Examining The Effectiveness Of Icu Diaries In Reducing Post–Intensive Care Syndrome (Pics) Psychological Symptoms: A Rapid Review Of United States–Based Studies, Lananh Tran

Honors Undergraduate Theses

Background: The growing recognition of Post-Intensive Care Syndrome (PICS) has prompted investigation into interventions, such as ICU diaries, to mitigate the long-term psychological effects of PICS. Intensive care unit (ICU) diaries – journals written by clinicians and loved ones during an ICU admission – are a tool that can help patients reconstruct the events of their critical care experience. Entries in the diary may include clinical updates, explanation of treatments, and encouraging words from loved ones or staff. Previous research in European countries found ICU diaries may be effective in reducing psychological effects post ICU admission.

Research question: The aim …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

Burnout And Workforce Outcomes Among Registered Nurses, Madeline Willcoxen

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationship between staffing and organizational support interventions and workforce outcomes among registered nurses providing direct patient care in hospital settings. The study focused on three measurable outcomes: emotional exhaustion, absenteeism, and annual nurse turnover. The population included hospital-based registered nurses, and the comparison involved standard staffing and support conditions.

Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2026 were identified using PubMed, CINAHL, Scopus, and PsycINFO databases. Inclusion criteria required quantitative studies examining staffing or organizational support interventions among registered nurses in …