Digital Commons Network^™

Human-Centered Ai For Nursing Workload Optimization: Advancing Clinical Quality And Reducing Burnout, Alexis Collier

International Nursing Research Congress (INRC)

Nursing professionals face increasing administrative and cognitive burdens that contribute to fatigue, burnout, and compromised patient safety. Despite the proliferation of electronic health records (EHRs), current systems often amplify rather than alleviate workload complexity. This study, developed under the AIM-AHEAD CLINAQ Fellowship, explores a human-centered artificial intelligence (AI) framework to optimize nursing workload distribution while promoting clinical equity and efficiency.

The project applies design-thinking methodology and interdisciplinary collaboration across informatics, data science, and clinical practice. Using EHR-derived activity logs and observational data, a predictive model was developed to identify high-intensity workflow patterns and recommend task reallocation strategies. The algorithm integrates …

Algorithmic Bias In Ai: Preparing Nurses For Critical And Culturally Safe Engagement, Claire Song, Tanvir Gill, Pamela Cawley

International Nursing Research Congress (INRC)

AI is increasingly used in healthcare and education, often framed as a tool for efficiency and objectivity. Yet, these systems are trained on data shaped by Western biomedical norms, reproducing structural and cultural biases. Deep learning does not create new knowledge; it reorganizes existing information. When that data-electronic health records, clinical trials, DSM-based tools- reflects Western perspectives, inequities are amplified under the guise of neutrality.

Consider mental health tools built on DSM frameworks, which pathologize non-Western expressions of distress. Despite the American Psychiatric Association’s 2021 acknowledgment of structural racism, AI-driven assessments still rely on instruments like PHQ-9 and GAD-7. Bias …

Beyond Surviving: Resilience In Advanced Practice Nursing Students, Gerard Thomas Hogan

International Nursing Research Congress (INRC)

Purpose: Advanced practice graduate nursing students (APGNS)—including nurse anesthesia, nurse practitioner, midwifery, and clinical nurse specialist students—face intense academic and clinical demands affecting mental health and learning outcomes. The shift from 24–28-month master’s to 36-month doctoral programs has amplified stressors, especially for nurse anesthesia students. This integrative review examines resilience development, measurement, and outcomes amid evolving educational demands.

Methods: Guided by Whittemore and Knafl’s integrative review method (2005), a systematic search of PubMed, CINAHL, Embase, and PsycINFO (2010–2025) identified 204 studies; 24 met inclusion criteria. Studies addressed resilience or related constructs among graduate nursing students. Quality appraisal used Joanna Briggs …

Current Icu Practices And Barriers To Calm Icu Guideline Uptake, Anne Mette Noerby Adams, Hila Dafny, Maria Alejandra Pinero De Plaza, Joanne Mcintyre, Xia Jin, Shailesh Bihari, Kay Bruce, Cherie Waite, Heather Block, Kathrine De Lyster, Frances Fengzhi Lin

International Nursing Research Congress (INRC)

Background: Agitation in the intensive care unit (ICU) can compromise patient safety, prolong recovery, and contribute to staff injuries. While pharmacological interventions are sometimes necessary, they carry risks such as oversedation, delirium, and prolonged mechanical ventilation. The CALM ICU guideline provides recommendations for the non-pharmacological prevention and management of patient agitation. However, guidance on how to implement these strategies in complex ICU environments remains limited.

Aim: To explore current ICU practices and stakeholder perspectives on the barriers and facilitators to implementing non-pharmacological strategies for managing agitation.

Methods: This mixed-methods study used an exploratory sequential design guided by the i-PARIHS framework. …

Research Into Practice: International Standards For Home Healthcare Nursing Practice, Mary Curry Narayan, Marilyn D. Harris, Susan M. Hinck

International Nursing Research Congress (INRC)

Introduction: Home healthcare nursing (HHN) is any nursing care provided in people’s homes. It includes low to very high acuity nursing services that people need throughout their lifespans (Narayan, 2025). Future trends predict nursing care around the world is migrating into people’s homes (Chabouh et al., 2023) because the home setting is frequently more patient-centered, more effective, and less costly than care in facilities (Rusli et al., 2025). HHN has a distinctive set of attitudes, knowledge, skills and goals (Hinck, 2022) that may vary by country. At the same time, the World Health Organization (WHO; 2025) encourages nurses to enhance …

Developing A Reliable And Valid Sbl Scenario To Ensure Fidelity In Nursing Research, Laura C. Sessions, Marguerite Lucea, Hayley Mark, Susan King

International Nursing Research Congress (INRC)

Background: The Healthcare Simulation Standards of Best Practice framework (1) guides the design of healthcare simulation and related research. These standards advance the science of simulation by enhancing rigor in simulation design to support interventional fidelity. Few studies describe how to achieve this goal (2,3,4). The aim of this study was to develop and validate a rigorous scenario to examine the impact of simulation-based learning (SBL) on nursing students’ self-efficacy in communicating about stigmatized health topics (e.g., intimate partner violence (IPV) and sexually transmitted infections (STIs)).

Methods: Content experts in IPV, STI, and SBL designed the scenario using a standardized …

Impact Of Sbirt And Virtual Simulation On Nursing Students’ Screening Readiness And Behaviors, Manal Alatrash, Muder Alkrisat

International Nursing Research Congress (INRC)

Purpose: This study examined changes in Bachelor of Science in Nursing (BSN) students’ screening readiness and practice behaviors related to substance use following Screening, Brief Intervention, and Referral to Treatment (SBIRT) education and training. It also evaluated the added impact of Kognito virtual simulation to identify areas for curriculum improvement.

Substance use disorder is a major public health issue, and nurses are key to early detection and intervention. Many nursing students reported feeling unprepared to address it (Myers et al., 2021; Quaye et al., 2020). SBIRT education improves knowledge, attitudes, and self-efficacy (Gomez et al., 2023; Zucker et al, 2022), …

Virtual Reality Communication Training In Health Professions Education: A Multi-Country Evaluation, Mohamad M. Saab, Mark O'Donovan, Irem Koç, Jennifer Kenny, Jan Hrdlička, Jiri Wild, Martin Zielina, Lucie Hrdličková, Katerina Rusinová, Martin Loučka, Aleksandrina Skvortsova, Liesbeth M. Van Vliet, Madelief Medema, Arianne D. Pieterse, Claudia Bausewein, Sabine H. Krauss, Johannes Rosenbruch, Stephanie Stiel, Kambiz Afshar, Malte Klemmt, Vasco Silva-Neves, Salomé Pinho, Ana Carolina Monteiro, Cathy Payne, Irene Hartigan

International Nursing Research Congress (INRC)

Purpose: Virtual reality (VR) is transforming nursing and medical education by providing immersive, safe, and realistic environments for developing skills [1-4]. The use of VR for teaching emotionally complex communication, such as delivering bad news, is underexplored [5,6]. This study evaluated the feasibility, usability, acceptability, and satisfaction with VR-based communication training among nursing and medical students and educators in Europe.

Methods: A cross-sectional study was conducted across six universities in five European countries. Two VR scenarios simulating “breaking bad news” were developed using the NURSE [7] and SPIKES [8] communication frameworks. Participants took part in a pre-briefing session, then engaged …

Professional Identity, Nurse Educator Competencies, And Job Satisfaction In Academic Nurse Educators, Lexi A. Ayala, Desiree Hensel

International Nursing Research Congress (INRC)

Background. A strong professional identity in nursing has been linked to safe practice and job satisfaction. However, the influence of professional identity on role competencies and job satisfaction in academic nurse educators is unclear. The ongoing nursing faculty shortage underscores the urgency of understanding this influence to help recruit and retain educators.

Purpose. Framed within the International Society for Professional Identity in Nursing domains and definitions and Benner’s Novice to Expert theory, this study investigates the relationships among professional identity, academic nurse educator competencies, and job satisfaction in US academic nurse educators.

Method. A total of 165 US nurse faculty …

Behavioral Emergencies: Workplace Violence? We Have A Plan (Bert Team Implementation), Marcia L. Ozdenvar, Mimi Olsson

International Nursing Research Congress (INRC)

During early 2024 we averaged 8.8 type-two workplace violence incidents increasing to 19 incidents in September. After workplace-related high-profile staff injuries occurred and our staff verbalizing increased concerns during patient interactions, staff were reporting practice changes to avoid patients they felt were agitated. A deficiency in staff on identification, mitigation and de-escalation of these patient behaviors (Bruccoli, 2023) was noted. The team evaluated best practices locally, regionally and within current literature, concluding that the implementation of a Behavioral Emergency Response Team (BERT) would be ideally suited to reduce workplace violence (Parker, et al. 2020).

Literature review identified the consistent effectiveness …

Effect Of Chatbot-Smlt On Self-Management And Quality Of Life Among Liver Transplant Recipients, Li-Chueh Weng, Wann-Yun Shieh, Wei-Chen Lee, Yu-Hsia Tsai, Ssu-Min Cheng

International Nursing Research Congress (INRC)

Background: After liver transplantation, patients must engage in effective self-management. Current care guidance needs to be more personalized, accessible, and continuous.

Objective: To explore the effects of an AI chatbot on the self-efficacy, self-management, and quality of life of liver transplant patients.

Subjects and Methods: This study employs a single-group pre- and post-test design. A chatbot was developed and implemented in March 2025, with data collection conducted during pre-testing, the first month, and the third month.

Results: This study presents the data analysis results for the 44 participants who used the AI chatbot. The average age of the 44 patients …

Coverage And Access Policies And Maternal Outcomes For Refugee Women: A Cross-Country Analysis, Sana Sahar Ebadi, Burhan Amiri, Roya Haghiri-Vijeh

International Nursing Research Congress (INRC)

Objective: This review will critically compare how national health coverage and access policies shape refugee women’s maternal outcomes across pregnancy, birth, and the first year postpartum in four selected countries (Canada, Germany, Australia, and the United States), and identify policies that negatively impact maternal outcomes of refugee women.

Introduction: Refugee and other migrant women frequently encounter host-country coverage and access rules that constrain antenatal, intrapartum, and postnatal care, and are associated with poorer maternal and perinatal outcomes (Aldridge et al., 2018; Fair et al., 2020; Heslehurst et al., 2018; ; Lebano et al., 2020; Mantini et al., 2017). Because these …

Development And Psychometric Evaluation Of A Medical Device-Related Pressure Injury Risk Assessment Scale, Ayise Karadag, Aleyna Uçanbelen, Öznur Erbay Dalli

Individual Articles

Medical device–related pressure injuries are a significant and largely preventable patient safety problem, yet existing pressure injury risk scales do not adequately capture device-specific risk factors in adults. This methodological study developed and psychometrically evaluated a standardized risk assessment scale to identify medical device–related pressure injury risk in hospitalized adult patients. An initial item pool was generated from an extensive literature review and clinical expertise, and content validity was assessed by seven experts using the Davis technique (content validity index = 0.96). The scale was administered to160 adults receiving at least one medical device in medical, surgical and oncology wards …

Icare System Implementation For Phlebitis Prevention: A Quality Improvement Study, Rini Rachmawaty, Agussalim Bukhari, Elly Wahyudin, Indra Gaffar, Sarah Bernadette L. Balena, Gulzar Malik

International Nursing Research Congress (INRC)

Background: Healthcare-associated phlebitis remains a critical challenge in Indonesian hospitals, where incidence rates reach 31.7%, dramatically exceeding the national benchmark of less than 1%. A major contributing factor is poor adherence to integrated clinical pathways, particularly concerning incompatible intravenous drug combinations such as ceftriaxone administered with calcium-containing solutions.

Objective: We aimed to reduce phlebitis incidence through implementation of an online integrated clinical pathway compliance system (iCare System) among patients with high-volume, high-risk, high-cost conditions at provincial government hospitals in South Sulawesi.

Methods: This prospective quality improvement study was conducted at Indonesian regional hospital, located in Makassar, between April and July …

Strategies For Early Diagnosis And Treatment Of Patients With Ovarian Cancer, Petrina Nicole Harrison

International Nursing Research Congress (INRC)

Background/Purpose: Ovarian cancer remains the leading cause of death among gynecologic malignancies, largely due to delayed diagnosis. Rural clinics face unique challenges, including limited access to specialists and diagnostic tools. This DNP quality assurance project aimed to evaluate and improve providers’ strategies for the timely diagnosis and treatment of ovarian cancer within a rural gynecology clinic serving women at increased risk for delayed detection and mortality.

Methods/Design: Using Avedis Donabedian’s structure-process-outcome framework, a retrospective chart review assessed adherence to evidence-based diagnostic and treatment practices. Findings informed the implementation of a Clinical Decision Support System (CDSS) integrated into provider workflows. Educational …

Using Greater Resilience Information Toolkit As A Transformative Strategy For Native American Women, Kathy Prue-Owens, Marie Zephier, Lauren Shaw, Nicole Weis

International Nursing Research Congress (INRC)

Background/Purpose: Native Americans (NAs) exhibit lower quality of life due to poverty, inadequate health services, historica/ongoing discrimination. NA women are underrepresented when it comes to the epidemic of violence, mental health and wellness outcomes.The purpose of this mixed method study was to explore the relationship between Native American (NA) women cultural beliefs, attitudes, and perceptions by gathering cultural input on the Greater Resilience Information Toolkit (GRIT) program.

Methods: This is a mixed-method community-based participatory research (CBPR) study. Self-efficacy is the theoretical framework. Upon Institutional Review Board approvals, flyers were posted at the tribal wellness center. Prior to focus groups, participants …

Adverse Childhood Experiences And Well-Being In Middle-Aged Korean Men: Mediating Role Of Andropause, Jeongok Park, Hyunju Lee, Gyeryung Park

International Nursing Research Congress (INRC)

Adverse childhood experiences (ACEs) can impact midlife well-being, however, their impact on middle-aged men is understudied. (1-5). This study aimed to examine the relationship between ACEs and well-being in middle-aged men, focusing on the mediating role of andropause symptoms to help develop strategies for improving men’s well-being.

This descriptive cross-sectional study included 444 community-dwelling men between the ages of 40 and 64 in Korea. Data were collected through an online survey. Individuals with psychological conditions impairing cognitive functions were excluded. Measures included PERMA-Profiler for well-being, ACEs International Questionnaire, and Androgen Deficiency in the Aging Males Questionnaire. SAS 9.4 was used …

Optimizing Nurse-Led Heart Failure Clinic Referrals Using A Heart Failure Readmission Risk Score, Marianne Rusin Borkosky

International Nursing Research Congress (INRC)

Background: Heart failure (HF) readmissions result in patients’ poor quality of life, depleted healthcare resources, reduced quality scores, and poor payor reimbursement, affecting healthcare systems’ financial stability. This is alleviated by referral to the HF Clinic. The project aims to compare HF Clinic referral rates after risk-assessing admitted HF patients with the European Collaboration on Acute Decompensated Heart Failure (ELAN-HF) risk tool to referral rates before the intervention. A goal is to utilize the ELAN-HF risk stratification tool to identify patients with the highest risk of readmission, refer them to the nurse-led HF Clinic, and provide self-care education and clinical …

Factors Influencing Quality Of Life In Liver Transplant Recipients: A Cross-Sectional Study, Jyun-Sian Wu, Yu-Ling Chang, Li-Chueh Weng, Kang-Hua Chen

International Nursing Research Congress (INRC)

Background: Liver transplant recipients must adapt to significant physiological and psychological challenges following surgery, including the side effects of immunosuppressants and the burden of chronic treatment. These stressors often cause symptom distress and impair quality of life (QoL). The sense of coherence (SOC), a psychological construct reflecting an individual’s ability to perceive life as comprehensible, manageable, and meaningful, has been associated with better coping and higher QoL. However, few studies have examined how SOC and symptom distress jointly influence QoL among liver transplant recipients.

Purpose: This study aimed to explore the relationships among demographic and clinical characteristics, symptom distress, SOC, …

Development And Validation Of A Risk Assessment Scale For Medical Device–Related Pressure Injuries, Ayise Karadag, Aleyna Uçanbelen, Öznur Erbay Dalli

International Nursing Research Congress (INRC)

Medical Device–Related Pressure Injuries (MDRPIs) pose a growing global challenge to patient safety, with incidence rates up to 19.3% [1]. MDRPIs are recognized as a nursing-sensitive quality indicator and excluded from hospital reimbursement systems, underscoring their clinical and economic significance [2,3]. Although largely preventable, accurate risk prediction remains limited due to the absence of MDRPI-specific tools for adults [4,5]. This study aimed to develop and validate a new, highly predictive risk assessment scale—MedRAS—to enable early identification and prevention of MDRPIs in adult inpatients.
This methodological and psychometric validation study included 160 adult inpatients using one or more medical devices. Data …

Global Nursing Education And Collaboration - A Peru Study Abroad Experience, Tuong Vi Ho, Jeri Striplin, Alicia Ramirez, Anh Tuyet Le, Van Nguyen

International Nursing Research Congress (INRC)

Background: To increase cultural competency in nursing students and to collaborate with other nursing schools globally, a study abroad program was established. This program focuses on the Peruvian culture and the improvement of the quality of life for the Peruvian population. Students were to gain insight into the differences and similarities of Peruvian and US healthcare issues, and immerse themselves in the Peruvian health care system with clinical practice alongside Peruvian nurses.

Method: This is a descriptive study. The group consists of 4 faculty and 32 students, from undergraduate to doctoral students. An in-country university collaborated with the group to …

The Tril Nurse Advocacy Model: A Practice-Grounded Framework For Sustainable Health System Change, Susanna Aba Abraham, Gifty Osei Berchie, Benjamin Kofi Anumel, Andrews Adjei Druye, Diana Bosomtwe-Duker

International Nursing Research Congress (INRC)

BACKGROUND: Advocacy is a professional nursing responsibility [1,2], and refers to speaking up or empowering marginalised individuals or groups [3]. Nursing advocacy requires "tending" to the needs of the community in which care occurs [4], thereby addressing the social determinants of health [5]. In 2025, the International Council of Nurses (ICN) redefined nursing with a call to extend advocacy beyond individual needs [4]. There is, however, a dearth of frameworks grounded in nursing practice that guide nurses in initiating and sustaining advocacy initiatives across the health system. This study therefore sought to describe the diverse strategies used in nurse-led advocacy …

Incorporating Global Perspectives Through Coil In Reproductive Health Nursing Education, Catherine Crawford, Rhonda Lanning, Elisabeth Hemnes Aanensen, Grethe Aarreberg

International Nursing Research Congress (INRC)

Global learning is based on the principle that the world is a collection of interdependent systems and that higher education plays a vital role in fostering learners' ability to advance equity and justice (Zhou, 2022). Collaborative Online International Learning (COIL) is a pedagogical approach which allows students to participate in virtual global learning activities encouraging development of critical thinking, creativity, problem-solving and teamwork skills, while enhancing recognition of diverse and global perspectives (Shaw et al., 2025) viewed as essential for safe patient care (Te et al, 2019). COIL has been in use in many universities in the United States and …

Psychometric Evaluation Of The 28-Item Brief Cope Scale Among Low-Income Parents, Jiying Ling, Dongjuan Xu, Yingcen Xie, Wen Liu

International Nursing Research Congress (INRC)

Purpose. The 28-item Coping Orientation to Problems Experienced Inventory (Brief COPE) is a widely used instrument assessing coping strategies among adults, but its reported factor structure has ranged from 2 to 15 factors across populations (Solberg et al., 2022), raising concerns about structural stability. Only one study has applied item response theory (IRT) to examine item-level performance in cancer patients and caregivers (Baumstarck et al., 2017). Thus, this study evaluated the psychometric properties of the Brief COPE among low-income parents using factor analysis and IRT.

Methods. We analyzed baseline data from three clinical trials conducted between 2021 and 2024. Participants …

Effectiveness Of Medical Clowns In Improving Emotion For Children Undergoing Invasive Treatments, Pao-Li Pan, Wei-Wen Wu, Cheng-Shi Shiu, Meng-Yao Lu, Leigh Lu

International Nursing Research Congress (INRC)

Background and Objective: Children diagnosed with cancer often find hospitalization and medical procedures confusing and distressing due to limited developmental understanding. Hospitalized children frequently experience heightened anxiety, especially during invasive procedures. Among psychosocial interventions, medical clowning has emerged as effective in improving emotional well-being. In Taiwan, past study suggested group-based medical clown services improve children’s emotional well-being, but evidence for individualized services—recently adopted in Taiwan—is limited. In other countries, individualized clown interventions before procedures, such as intravenous insertion or surgery, significantly reduce anxiety and distress. This study aims to evaluate the effectiveness of individualized medical clown services in enhancing the …

Effect Of Role Ambiguity On Turnover Intention: A Moderated Mediation Model, Heejin Lim, Seung Eun Lee

International Nursing Research Congress (INRC)

Purpose: Given nurses’ high turnover and its impact on patient safety and quality of care (Wu et al., 2023), reducing their turnover intention is crucial. This study aimed to (a) test the direct effect of role ambiguity on turnover intention, (b) examine the indirect effect via burnout, and (c) investigate whether physician–nurse collaboration moderates the path from role ambiguity to burnout and, consequently, the conditional indirect effect (moderated mediation) on turnover intention.

Design/Methods: This descriptive, correlational study analyzed data from 507 registered nurses in South Korea collected between October and December 2024. Eligible participants had at least one year of …

“I Started Healing Myself”: Black Mothers’ Grief Journeys After Stillbirth, Carrie J. Henry, Sara Kaylor, Mallory Scogin

International Nursing Research Congress (INRC)

Introduction: Stillbirth (fetal death after 20 weeks gestation) occurs twice as often for Black mothers compared to White in the United States (Gregory et al., 2024), yet limited research has explored how Black mothers cope with stillbirth-related grief and distress (Boyden et al., 2014; Henry et al., 2023). Evidence suggests coping behaviors after perinatal loss differ across cultural and racial groups (Henry et al., 2024; Moore et al., 2022), yet most studies reflect mostly White samples. Understanding how Black mothers navigate the grieving process is essential to inform culturally responsive care and bereavement support (Fenstermacher & Hupcey, 2019; Henry et …

The Mediating Role Of Resilience Between Anxiety And Depressive Symptoms, Marivic Torregosa

International Nursing Research Congress (INRC)

Objective: This study examined the mediating effect of resilience between anxiety and depressive symptoms while controlling for alcohol intake, anxiety, and selected demographic variables.

Method: After obtaining IRB approval, data were collected from a sample of n = 514 students at a Hispanic-serving institution located on the United States-Mexico border from 2020, during the COVID-19 pandemic, through 2023. The instruments used were the Generalized Anxiety Disorder 7-item scale (GAD-7) to measure anxiety, the Patient Health Questionnaire-9 (PHQ-9) to measure depressive symptoms, and the Brief Resilience Scale (BRS) to measure resilience. Path analysis was used to analyze the mediating effect of …

The Accelerated Apprenticeship Model: An Innovative, Collaborative Solution, Lauren L. Niles, Misty Smith, Sheila S. Gentry, Shikha Modi, Charles Reynolds

International Nursing Research Congress (INRC)

Nursing shortages continue to plague our profession. It is projected that the nation will face a nursing shortage of 78,610 full time nurses in 2025 (National Center for Health Workforce Analysis, 2022). Nursing graduates are also leaving the profession prematurely (Tate, 2024). In 2025, approximately 22.3% of registered nurses (RNs) left their positions within the first year of work (NSI Nursing Solutions, Inc., 2025). Leaders in nursing education continue to seek novel methods to increase the number of practice-ready graduates. The need to better provide graduates with the necessary knowledge and skills for early practice presented an opportunity to create …

Using An Outcome-Based Education Design To Drive Dissemination Of Nursing Work, Kathleen Bradley, Ningning Guo

International Nursing Research Congress (INRC)

Nursing work dissemination often begins with a national podium or poster presentation. Submitting an abstract to these professional conferences can be challenging and time-consuming for novice writers. The American Nurses Credentialing Center (ANCC) Outcome-Based Continuing Education (OB-CE) model was used as a framework to design a hands-on Abstract Writing Workshop to help learners embark on their dissemination journey (ANCC, 2021; ANCC, 2025).

In September 2022, an environmental scan revealed less than fifty percent of projects were disseminated beyond the unit of improvement. Additionally, many nurses lacked knowledge and skills of abstract writing, often the first step in the dissemination process. …