Digital Commons Network^™

Unintentional Medication Discrepancies In Outpatient Cardiac Procedures: Identifying Modifiable Barriers, Julie M. Turner

DNP Projects

Background: Medication reconciliation (MR) reduces medication errors during care transitions; however, unintentional medication discrepancies (UMDs) remain common due to variable practices and lack of standardization. Patients undergoing elective cardiac procedures are particularly vulnerable given complex medication regimens.

Purpose: This quality improvement project evaluated implementation of a Medication Reconciliation Barrier Identification Checklist (MRBIC) in the cardiac catheterization laboratory to identify patient, staff, and system-level contributors to UMDs.

Methods: A quasi-experimental pre–post design was conducted at a large academic medical center. During a six-week intervention, nurses and providers completed the MRBIC during pre-procedure MR. Barrier scores were compared with …

Advancing Rural Health Equity Through Systematic Sdoh Screening- A Quality Improvement Initiative, Laura C. Combs

DNP Projects

Background: Social determinants of health (SDoH) significantly affect health outcomes and healthcare utilization, particularly in rural communities. In 2024, the Centers for Medicare & Medicaid Services mandated SDoH screenings in the inpatient setting, with recommendation to implement in rural clinics without specifying a standardized tool, resulting in inconsistent identification of needs, e.g., food insecurity, housing instability, mental health concerns, financial strain, and transportation barriers.

Purpose: This quality improvement initiative implemented a standardized SDoH screening tool in a rural outpatient clinic to evaluate changes in referral rates to community-based resources pre- and post-implementation and to improve patient reporting of social needs. …

Building Confidence And Team Communication: Implementation Of A Rapid Response In Situ Simulation Program In The Neonatal Intensive Care Unit, Janell F. Hacker

DNP Projects

Background: Neonatal code events are high-risk, low-frequency occurrences in the neonatal intensive care unit (NICU). Simulation-based training is used to support skill development, maintain competencies, and enhance team performance.

Purpose: The purpose was to determine if a multidisciplinary, high-fidelity, rapid response in situ simulation program would impact confidence and communication among frontline healthcare providers during neonatal code events.

Methods: A quasi-experimental, pretest-posttest study was conducted in a 90-bed Level IV NICU. A multidisciplinary, high-fidelity in situ rapid response simulation program was implemented over a 3-month period for frontline NICU healthcare providers. Pre- and post-surveys assessed perceptions of role clarity, …

Improving Compliance With Preoperative Antibiotic Protocols For Cardiac Implanted Electronic Devices: A Quality Improvement Project, James Kaup

DNP Projects

Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained …

Implementing A Standardized App-Led Multidisciplinary Medication Review And Reconciliation To Improve Medication Safety Before Systemic Cancer Therapy: An Ambulatory Oncology Quality Improvement Initiative, Sarah R. Hines

DNP Projects

Background

Adult patients initiating systemic cancer therapy frequently present with pre-existing polypharmacy related to chronic comorbidities and cancer-related symptom management. The addition of anticancer therapies and supportive care medications further increases medication burden and the risk of medication-related harm. Although national organizations and institutional policies recommend comprehensive medication review before treatment initiation, implementation remains inconsistent in ambulatory oncology practice.

Purpose

To implement and evaluate a standardized Advanced Practice Provider (APP)-led multidisciplinary medication review and reconciliation process designed to identify medication medication-related safety risks before initiation of systemic cancer therapy in adult oncology patients receiving care in an ambulatory infusion center. …

Impact Of Land Use On Soil Properties, Clay Mineralogy, And Behavior Of Ammonium Across A Precipitation Gradient, Isabel Delamater

Theses and Dissertations--Plant and Soil Sciences

Like soil texture, clay mineralogy is considered a permanent or inherent characteristic of soils reflecting the influence of soil forming factors over long periods of time. Despite the importance of clay mineralogy in providing ecosystem services, much remains unknown about whether land use (native grassland sod versus no-tillage) can modify clay mineralogy under short periods of time. Furthermore, in no-tillage agroecosystems, lower crop yields are often ascribed to immobilization of added N fertilizer where inorganic nitrogen (such as ammonium) is converted to organic nitrogen. The possible role of clay mineralogy in retaining added ammonium has been overlooked in no-tillage systems. …

Integrated Crop Management For Hemp (Cannabis Sativa L.) Grain Production In Kentucky, Maria M. Ricciardi

Theses and Dissertations--Plant and Soil Sciences

Cannabis sativa L. is legally defined (U.S.) as hemp if the total tetrahydrocannabinol (THC) concentration remains less than 0.3% on a dry weight basis. Hemp can be produced for cannabinoid extraction, fiber, or grain. Hempseed meal and hempseed oil were approved as feed ingredients for chickens and performance horses in Kentucky. To leverage this opportunity, production requires improvement through an integrated crop management approach. This dissertation (1) reports the main arthropod and disease pests impacting hemp grain; (2) identifies grain yield components and their relationship with corn earworm, Helicoverpa zea (Boddie) (CEW); (3) evaluates Fusarium head blight (FHB) development across …

Effects Of Student And School Technology Adoption On Student Reading Achievement In The United States: The Case Of Pisa 2018, Mikah J. Hughes

Theses and Dissertations--Educational, School, and Counseling Psychology

This study examined the relationship between student and school-level information and communication technology (ICT) factors and reading achievement using data from the Programme for International Student Assessment (PISA) 2018 in the United States. In an increasingly digital world, reading and information literacy are essential skills, yet significant gaps in digital competencies persist. This study investigated how ICT access, use, and perceptions relate to reading achievement in the context of student and school background factors.

A two-level hierarchical linear modeling (HLM) framework was employed to account for the nested structure of students within schools. The sample included approximately 4,000 students across …

Characterization And Antimicrobial Activity Of Lignin-Derived Compounds In Ground Hurd Tissue Of Cannabis Sativa L. (Hemp) Cultivars, Jourdan E. Lakes, Anjam Sadik, Robert C. Pearce, Barbara L. Knutson, Stephen E. Rankin, Bert C. Lynn, Michael D. Flythe

Chemistry Faculty Publications

Objectives: Characterize lignin-derived compounds from the hurd of 10 fiber/grain Cannabis sativa L. cultivars and investigate the antimicrobial activity of select compounds on the wasteful ruminant bacterium, Acetoanaerobium sticklandii SR.   Methods: Hurd was processed using an aqueous ethanol solvent system and analyzed via GC-MS to identify and characterize lignin derivatives. Antimicrobial activity of the hurd and three monomers was assessed using solid (hurd) and liquid medium (monomers) bioassays against SR.   Results: 27 compounds were identified, most as monomers but a few were dimers, ethylated derivatives, and organic acids. There were approximately equal G- and S-units with substantially fewer H-units. Several …

Analytical Commentary And Performer's Guide To Carlos R. Martinez's Four Pieces For Trombone, Bailey Jean Hardy-Price

Theses and Dissertations--Music

Musicians with hearing loss are documented in prominent figures, such as Ludwig van Beethoven. In the age of developing medical technology, hearing aids can turn the course for many musicians. Music can serve as an audio medium for this journey.

Carlos R. Martinez (b. 1978) is an active composer and pianist commissioned to create a piece that explores the journey of hearing loss in a musician. Martinez’s Four Pieces for Trombone and Piano illustrate a musician’s discovery of their hearing loss, its consequences, and joy in implementing the use of a hearing aid. The detailed discussion of the composer and …

Investigation Of Succinylated Zwitterionic Polyethylenimine/Dna Complexes: Performance In Serum, Internalization, And Intracellular Fate, Levi Lampe

Theses and Dissertations--Chemical and Materials Engineering

Gene therapy has promised to revolutionize medicine since the earliest clinical trials, but a lack of delivery methods that are both safe and efficient has hampered progress. Gene therapy with viral vectors is effective at delivering nucleic acids to cells, but is associated with dangerous immunogenic responses and cancer-causing insertions into the genome. Viral vectors are also among the most prohibitively costly therapeutics in medicine. Polymeric vectors avoid these dangers and are made from inexpensive, off-the- shelf materials, but have been hindered by poor efficiency compared to viral vectors.

A benchmark polymer for in vitro nucleic acid delivery has been …

Leading On An Uneven Playing Field: How Systems Of Race And Gender Shape African American Women’S Leadership Advancement, Nikki Goins-Hughes

DSW Capstone Projects

Systemic barriers to leadership for African American women are deeply rooted in historical and structural inequities within the United States. Intersecting identities of race and gender have historically shaped access to leadership advancement opportunities for African American women. Despite efforts to prioritize gender and racial equity in leadership, African American women continue to experience exclusion or are highly scrutinized in decision-making spaces, contributing to their continued marginalization in leadership. Therefore, this capstone draws on a systematic literature review, conceptual framework, and practice application to examine the systemic barriers that limit access to leadership advancement opportunities for African American women and …

Navigating Mental Wellness: A Peer-Led Journey Into Adult Services, Kristin G. Haberek

DSW Capstone Projects

Students with severe emotional disturbances (SED) occupy one of the most underserved intersections in American education and mental health care. As they age out of children’s services, they face abrupt service discontinuation, disrupted therapeutic relationships, and adult systems ill-equipped to meet their needs. These vulnerabilities, including heightened risks of crisis, hospitalization, homelessness, and justice involvement, constitute a central practice problem. This capstone addresses these transitions across three scholarly products: a systematic literature review, a theoretical concept paper, and a practical application paper, tracing a unified arc from diagnosing structural failures to proposing an evidence-informed, equity-oriented clinical response. Synthesizing key findings …

Amustaline/Glutathione Pathogen-Reduced Red Cell Hemoglobin Utilization In Complex Cardiac Surgery, Ian J. Welsby, Michael E. Sekela, Edward L. Snyder, James D. Gorham, John S. Mcneil, Kathy Liu, Stanley Bentow, Thomas Gniadek, Laurence Corash, Nina Mufti, Richard J. Benjamin

Surgery Faculty Publications

Background: The ReCePI randomized, controlled trial compared amustaline/glutathione pathogen-reduced (PR) and conventional red blood cell (RBC) transfusions in cardiac surgery. Study design and methods: We performed a post-hoc analysis of hemoglobin (Hb) utilization and safety outcomes. Hb content of study RBCs was measured at manufacture. Subject Hb levels, estimated blood loss and blood product use were recorded during and for 7 days post-surgery. Acute kidney injury (AKI) incidence was graded over 7 days, and adverse events were assessed for 28 days. Results: PR-RBCs contained 5.2% less Hb (mean [SD] Test 58.1 [6.5] g; Control 61.5 [6.8] g Hb, p <.001) due to manufacturing volume losses. Four hundred fifty-six PR- and 524 conventional RBCs were transfused to 159 Test and 162 Control subjects, respectively. Mean subject baseline and post-surgery Hb levels, and blood loss were not different between groups. Test subjects tended to require fewer total RBCs (3.5 [2.7] Test vs. 4.0 [3.5] Control, p =.08) resulting in 17.6% significantly less mean total Hb transfused (Test 203.2 g; Control 246.8 g Hb, p =.01). The proportions of subjects transfused with, and the number of platelet and cryoprecipitate units transfused were not different. Test subjects received less plasma (2.3 [1.8] units Test vs. 3.5 [3.8] Control, p =.03). Overall incidence of adverse events and AKI were not clinically different. Imbalances in AKI severity (Grade III Test 15/159 [9.4%]; Control 7/162 [4.3%], p =.07) may suggest under-transfusion in the highest-risk Test subjects. Discussion: Test patients required less transfused Hb than control subjects to maintain equivalent daily hemoglobin levels following similar blood loss.

Prolonged Invasive Mechanical Ventilation Is Associated With Decreased Survival After Lung Transplantation Among Recipients With Primary Graft Dysfunction, Meghan Aversa, Shaf Keshavjee, Tereza Martinu, Marcelo Cypel, Andrew T. Sage, Joshua M. Diamond, Jonathan P. Singer, Scott M. Palmer, Krishna Pandya, Edward Cantu, Jason D. Christie, Michaela R. Anderson

Surgery Faculty Publications

Introduction: Prolonged invasive mechanical ventilation (IMV) after lung transplantation is an appealing early prognostic outcome as it can be reproducibly assessed both prospectively and retrospectively. Whether use of IMV at 72 h after lung transplantation is associated with post-transplant graft survival is unknown. Methods: We performed a retrospective cohort study of 1511 participants in the multi-center Lung Transplant Outcomes Group cohort (2011–2018). Using Cox proportional hazards models and restricted mean survival time, we investigated whether IMV at 72 h was associated with post-transplant graft survival. We secondarily evaluated whether IMV at 72 h was concordant with severe primary graft dysfunction …

Mouse Models For Post-Sepsis Syndrome, John Matthew K. Ang, Stephanie F. Mori, Erick Lewis, Maria E.C. Bruno, Arnold Stromberg, Hiroshi Saito

Surgery Faculty Publications

Background – Sepsis survivors commonly suffer from chronic Post-Sepsis Syndrome (PSS). To understand the mechanisms of PSS, it is critical to utilize appropriate animal models. While cecal ligation and puncture (CLP) is a widely used model of sepsis, a concern exists regarding its suitability for studying long-term outcomes. Alternatively, we previously optimized a highly reproducible murine cecal slurry (CS)-injection model of sepsis. The objective of this study was to compare the suitability of CS and CLP models for investigating PSS. Methods – Male 4-month-old C57BL/6 mice were divided into 7 groups: (1) Naïve control; (2) Sham: laparotomy control; (3) CL: …

Scrolling, Searching, And Self-Diagnosing: Examining How Social Media Influences Self- Diagnosis And Shapes Mental Health Literacy, Conceptualization, And Identity Development, Sara Elaine Hamilton

DSW Capstone Projects

This capstone examines the influence of social media on the growing issue of self-diagnosis of mental health disorders through three scholarly works: a systematic literature review (SLR), a conceptual paper, and practice application paper. Accessibility, anonymity, and social isolation are identified as contributing factors of self-diagnosis, as individuals increasingly prioritize convenience over traditional help-seeking methods. Research suggests that self-diagnosis is influenced by misinformation and reinforced by validation and a sense of belonging, leading individuals to internalize mental health disorders as part of their identity. Findings further indicate that social media plays a significant role in the dissemination of misinformation about …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Investigating Intersectionality: How Multiple Marginalized Identities And Social Perceptions Of Victims Influences The Efficacy Of Panic-Defense Narratives In Bathooms, Demitri James Aguilar

Theses and Dissertations--Psychology

Despite transgender Women of Color being the main victims of violent victimization and panic-narrative cases, very little research has investigated how race/ethnicity might impact perceptions of violence or the influence of panic-narratives. Thus, the current experiment (N = 1275) examined the social and legal ramifications of using panic-narratives against transgender and cisgender women of color (Black vs. Latino vs. White) in bathroom victimization contexts. The predictions were partially supported. Regardless of racial identity, the justification of transgender (versus cisgender) victimization via panic-narratives produced more anti-victim (e.g., increased victim guilty verdicts, sentencing, victim culpability, perceived deception, and threat) and prodefendant outcomes …

Effect Of Substrate Dispersion Method And Particle Size On In Vitro Digestibility, Gas Production Kinetics And Composition, And Fermentation Characteristics In Different Feed Types, Luiz C. O. Sousa, Ellem M. A. Matos, Ronald J. Trotta, Edenio Detmann, David L. Harmon

Animal and Food Sciences Faculty Publications

Our objective was to evaluate the influence of substrate dispersion method and particle size on in vitro digestibility, gas production kinetics and composition, and fermentation characteristics of different feed types. Alfalfa hay, tall fescue hay, ground corn, soybean meal, and a total mixed ration (TMR) were used as substrates. Treatments were designed according to a 2 × 2 × 5 factorial arrangement: two substrate dispersion methods (loose substrate and in filter bags), two particle sizes (1 mm and 2 mm), and five feeds. Filter bags decreased (P ≤ 0.001) digestibility and gas production compared with loose samples. Filter bags decreased …

Stressful Life Events And Ocd Treatment: A Thematic Analysis Of Patient Perspectives, Emily E. Fenlon

Theses and Dissertations--Psychology

Trauma exposure, including interpersonal violence (IPV), is associated with increased risk and severity of obsessive-compulsive disorder (OCD). Exposure and response prevention (ERP) is the treatment of choice for OCD, yet research suggests a history of trauma and comorbid PTSD may adversely impact treatment outcomes. No studies have yet evaluated patient perspectives on the relationship between trauma, IPV and related sequelae and OCD treatment. The present study applies reflexive thematic analysis to interviews from individuals with a history of IPV who received exposure-based therapy for OCD. Interviews explored the influence of posttraumatic distress, impairment, and psychopathology on the treatment of OCD, …

Menstrual Cycle Phase Effects On Alcohol-Impaired Driving Performance And Risk Awareness, Annie K. Griffith

Theses and Dissertations--Psychology

Growing evidence indicates that risky behavior among women is elevated during the late follicular phase of the menstrual cycle, likely due to increased estradiol levels. Furthermore, alcohol-induced impairment of women’s inhibitory control is significantly greater during the late versus early follicular phase. Consequently, cycle phase may influence outcomes of poor inhibitory control while intoxicated, such as alcohol-impaired driving. Alcohol-impaired driving risk manifests in two ways: risk-taking while driving, and risk awareness regarding the decision to drive. This dissertation tested the hypothesis that alcohol-induced increases in driver risk-taking and decreases in risk awareness would be exacerbated during the late versus early …

The Relationship Between Estradiol And Progesterone Concentration Levels, Alcohol Consumption, And Inhibitory Control, Layne Elizabeth Robinson B.S.

Theses and Dissertations--Psychology

Alcohol use is increasing among women, with estimates for binge drinking having risen to levels similar to those seen in men. Despite this trend, sex differences regarding mechanisms of alcohol consumption have seldom been investigated. Our group and others have found evidence to suggest that ovarian sex hormones are associated with alcohol consumption and mechanisms that might be related to alcohol consumption, such as executive function deficits. The current study sought to extend this prior research in a larger sample with higher drinking rates and more rigorous methods, and to explore inhibitory control associations with drinking. Across the two samples …

Next-Day Effects Of Binge Drinking On Inhibitory Control In Laboratory And Naturalistic Settings, Justin Verlinden

Theses and Dissertations--Psychology

Binge drinking occurs at an alarmingly high rate, despite its negative consequences on behavior, health, and cognition. One acute cognitive consequence of binge drinking is the impairment of inhibitory control, or the ability to stop oneself from engaging in maladaptive or inappropriate behaviors. Specifically, during a binge episode, individuals display impaired inhibitory control while completing Go/NoGo or Stop Signal Tasks (SST). This impairment has been shown to be maintained for up to five hours post-drinking, even as breath alcohol concentration (BrAC) approaches zero. Evidence also suggests that binge drinking results in next-day deficits in attention, memory, and psychomotor speed. However, …

Comparing Domain- And Facet-Based Models Of Personality Disorder: Incremental Predictive Validity And Model Fit, Alexandra Hines

Theses and Dissertations--Psychology

Personality disorders (PDs) have historically been conferred using a categorical diagnostic framework (i.e., present versus absent). However, recent research supports a transition toward dimensional models of PDs wherein personality traits are measured along a continuum. Some dimensional models contain personality domains only, whereas other models contain both personality domains and facets of each of those domains. The leading models of each type are the PD model in the eleventh edition of the International Classification of Diseases (ICD-11) and the Alternative Model of Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), respectively. …

A Mixed Method Investigation On The Effects Of Information And Motivation On Self-Regulation Skills And Fruit And Vegetable Consumption, Kristen Buford

Theses and Dissertations--Psychology

Introduction: The purpose of this research study is to understand the interplay between health information and health motivation on eating behaviors in African American emerging adults. Greater knowledge of nutrition is linked to healthier eating outcomes, but the motivations that individuals possess about their ability to improve their health also play a pivotal role. However, the joint effect of such constructs (i.e., information and motivation) on eating behaviors is unknown. Emerging adults are still developing their capacities to exercise their health autonomy, and this developmental period represents an opportunity to intervene before the onset of age-related chronic diseases in middle …

Correlates Of Recovery Capital Among Women In Jails: Leveraging A Dimensional Recovery Framework, Amanda Fallin-Bennett, Martha Tillson, Jaxin Annett, Hartley Feld, Michele Staton

Nursing Faculty Publications

Background: Recovery capital encompasses internal and external factors that support recovery from substance use disorder, such as employment, social support, and physical and mental health. There is a need for more research on recovery capital among women who are incarcerated, who often face complex barriers to recovery, such as poverty, unemployment, and histories of trauma.

Methods: Women (N ¼ 900) were recruited from Kentucky jails as part of the broader NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative project. Measures from baseline interviews (during incarceration) were selected in alignment with the Substance Abuse Mental Health Service Administration (SAMHSA)’s four …

“Being Treated As The Expert:” A Blueprint For A Community Advisory Board Approach To Elevate The Voice Of People With Living Experience With Substance Use In Academic Research, Trevor Moffitt, Survivors Union Of The Bluegrass, Bryson Henson, April M. Young, Sharon L. Walsh, Rachel Vickers-Smith, Junior Cruz, Jeremy Byard, Brook West, Amanda Fallin-Bennett

Nursing Faculty Publications

Introduction: Researchers have traditionally engaged Community Advisory Boards (CABs) to meaningfully involve community members in the research process. However, CABs are often formed only after a grant is funded, leading to criticisms of functioning merely as “ethical approvers.” For substance use researchers, the inclusion of people with living experience (PWLE; current experience with drug use) across all stages of research is especially important as they have historically been the experts in the needs of their community.   Methods: In response to this need for community engagement in research, the University of Kentucky, in partnership with a local recovery community center (RCC; …

Coalition Building And Citizen Science For Radon Risk Reduction, Stacy Stanifer, Kathy Rademacher, Whitney Sedio, Naomi Cheek, David Gross, Caitlyn Curtis, Amanda Thaxton-Wiggins, Mary Kay Rayens, Ellen J. Hahn

Nursing Faculty Publications

We evaluated the implementation of local coalitions led in partnership with citizen scientists, community-based organizations, and public libraries in four rural communities to lower exposure to radon in the home. The objectives were to (1) describe the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) of four radon coalitions, and (2) compare RE-AIM factors among citizen scientists who participated in the coalitions and those who did not. A larger community-engaged research project embedded coalition building using a citizen science approach. Three of the four coalitions focused on health and wellness more broadly (18–34 members); one focused solely on radon (10 members). Coalition membership and activities varied …

Evaluation Of A Tobacco Treatment Specialist Training Program Targeted To Behavioral Health Professionals, Chizimuzo T. C. Okoli, Sarret Seng, Bassema Abu Farsakh, Emily Koyagi, Heather Beck, Audrey Darville

Nursing Faculty Publications

Tobacco use remains disproportionately high among adults living with mental illnesses (MIs), contributing to excess morbidity and mortality, particularly in high-burden states such as Kentucky. Behavioral healthcare providers are well-positioned to address this disparity but often lack formal training in evidence-based tobacco treatment. Tobacco Treatment Specialist (TTS) training provides healthcare providers with skills to deliver evidence-based tobacco treatment; however, traditional TTS training models often rely on synchronous, in-person or live virtual formats, which may limit accessibility for some healthcare workforces. Asynchronous, web-based delivery models may reduce these barriers. This study evaluates a targeted, asynchronous TTS training program designed for providers …