Digital Commons Network^™

Optimizing Electronic Health Record Workflow To Improve Flu Vaccinations In A Primary Health Clinic, Xzalyn Arianah Hernandez

Master's Projects and Capstones

Among the Latinx population influenza vaccination rates remain disproportionately low due to vaccine hesitancy, misinformation, limited access to healthcare, and socioeconomic barriers. Influenza related hospitalizations and deaths have risen in recent years as rates continue to drop across all age groups, as a result of this issue. This quality improvement project aims to increase staff satisfaction and flu vaccination rates among Latinx patients by the implementation of a more efficient workflow process. Different interventions were designed to address workflow inefficiencies and medical assistant dissatisfaction. These interventions included 1) integrating the Immunization Clinic function in EPIC to streamline flu vaccine documentation …

Reducing Hospital-Acquired Pressure Injuries Through Targeted Nurse Education On The Braden Scale And Skins Bundle, Sarah Nicole Farkas

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) continue to rise nationally despite overall reductions in other hospital-acquired conditions. This project sought to address gaps in nurse knowledge, inconsistent prevention practices, and workflow barriers contributing to HAPI development on a Trauma Medical-Surgical Unit (Unit A). Aim: This project aims to decrease the number of HAPIs on the Trauma Medical Surgical Unit by 11%, from nine HAPIs to eight HAPIs, following implementation of nurse education on the proper use of the Braden Scale and the SKINS Bundle from October 6, 2025, to November 14, 2025. Methods: A pre-intervention survey was administered to identify baseline …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Bridging Gaps In Safety: A Team-Based Approach To Reducing Falls Among Older Adults, Enzali Min

Master's Projects and Capstones

A skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility's fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving the …

Stop, Look, And Save A Spot! Implementing The Hapi Prevention Tool, A Visual Cuing System That Aims To Reduce Hospital-Acquired Pressure Injuries In Acute Care Units, Jada Baldoza

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries continue to be a major challenge in many healthcare settings as it poses increased risk in patient safety. Additionally, it creates a significant financial burden on hospitals as it increases operational costs that can increase strain on healthcare resource demands. Nurses play a major role in mitigating these injuries through practicing quality patient care and utilizing prevention strategies that have been proven effective. Aim: A quality improvement project was conducted by introducing a visual cueing system, the HAPI Prevention Tool to investigate its potential sustainability on reducing HAPI rates in the medical-surgical unit. Methods: The QI …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Implementing A Standardized Doula Awareness Tool To Improve Team Collaboration And Patient Understanding, Stephanie Wong

Master's Projects and Capstones

Setting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently …

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …

Lost In Translation: Navigating Cultural And Linguistic Barriers For Indian Learners In Tesol Classrooms, Shivam Jaynarayanbhai Gohel

Master's Projects and Capstones

ABSTRACT

This thesis examines the cultural, linguistic and emotional issues of the Indian multilingual students in the U.S. TESOL classroom and explains the value of decolonized and culturally responsive pedagogies to ameliorate foreign language anxiety and create equitable education. Based on the frameworks of Culturally Responsive/Sustaining Pedagogy and Affective Filter Theory, the study integrates existing and existing research to investigate the role of colonial heritage in influencing TESOL practice, the undermining effect of anxiety on academic achievement and the empowering effect of instructions that are inclusive and responsive. Chapter I presents the problem, including how multilingual and multicultural identities of …

What We Can Learn From Comenius About Why We Educate, David I. Smith

University Faculty Publications and Creative Works

As we wrangle repeatedly over the purposes of schooling and who gets to define them, what might we gain by taking a moment to listen to a thoughtful voice from a place and time not defined by our own mix of prejudices? I invite you to listen to such a voice, one speaking from a different era amid different anxieties and in a different idiom yet addressing questions that remain pressing. It is a voice shaped by a lifetime of educational engagement and reflection in the constant shadow of violence, yet, to the last, invested in the pursuit of delight. …

Policy Library- 210 Admissions, Indiana State University, General Counsel

Policy Library

Policy 210 Admissions

Policy Library- 147 University Curriculum, Assessment, And Student Success Committees, Indiana State University, General Counsel

Policy Library

Policy 147 University Curriculum, Assessment, and Student Success Committees

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Factors Associated With Initial Psychogenic Non Epileptic Seizures (Pnes) Amongst Patients With/Without Epileptic Seizures (Es), Enow Ogork

Walden Dissertations and Doctoral Studies

Psychogenic nonepileptic seizure (PNES) is an important individual and public health concern, but inconsistent results exist in the literature in terms of the circumstances surrounding the initial occurrence of PNES among patients without a prior diagnosis of epilepsy. The purpose of this study was to determine to what extent patient sex, number of medical comorbidities, sleep deprivation, head injury in the past, and eyes closed during seizures predict initial PNES among patients with or without PNES. The precaution adoption process model provided a framework for exploring how individuals become aware of health risks and decide to adopt preventive behaviors. Secondary …

Assessing The Efficiency Of Methods To Teach Adolescents About Testicular Cancer And Testicular Self-Examination, Ayşe Gül Güven, Laden Jafari̇, Murat Doğuş Günel, Özlem Akbulut

Turkish Journal of Medical Sciences

Background/aim: Due to the increasing incidence of testicular cancer (TC), early testicular self-examination (TSE) in adolescent males is crucial for early detection and treatment. However, it is uncertain which method is best for teaching about TC and TSE in this age group. This study aimed to assess the effectiveness of formal (face to face with model) and informal (video presentation) approaches in male adolescents about TC and TSE.Material and methods: This intervention study was conducted in 2 high schools, and included a study group (n = 142) and a control group (n = 102). In the study group, a video …

The Relationship Between Light Physical Activity And 10-Year Weight Change In 2,868 U.S. Adults: A National Health And Nutrition Examination Survey Investigation, Chloe Diane Cory

Theses and Dissertations

The prevalence of obesity has steadily increased over the past several decades. About 13.4% of Americans aged 20-74 had obesity in 1960-1962 and the prevalence has steadily increased to 40.3% in 2021-2023--more than a 3-fold increase. PURPOSE: The aim of this study was to evaluate the relationship between time spent in light physical activity (LPA) and 10-year weight change in a random sample of 2868 women and men representative of the U.S. adult population. METHODS: Data were used from the National Health and Nutrition Examination Survey (NHANES) from the 2003-2006 data cycles. Participants were limited to non-pregnant U.S. …

Women Made By Oscar Wilde, Lia Fowler

Departmental Honors & Graduate Capstone Projects

This analysis examines Lady Windermere’s Fan and An Ideal Husband, arguing that Oscar Wilde categorizes women within restrictive moral binaries of “good” and “bad.” Both plays depict women navigating social expectations, private honor, and the idea of a pure marriage; however, despite their central roles, female characters are not portrayed as empowered with appropriate agency. Wilde renders the women as contradictory, dangerous, shifty figures if they try to operate outside of marital bounds. While Wilde’s plays foreground women in prominent positions, they largely reinforce, rather than challenge, the gendered stereotypes of late Victorian society.

Ai-Assisted Literary Analysis In A Flipped Classroom Model: Fostering Critical Engagement, Tizziana Valdivieso, Jules Lemus Gonzalez

Teaching Repository of AI-Infused Learning

The activity was structured into four phases: in the preparation phase, students built a common knowledge base by reading about Salvadoran social issues through literature. During the controlled and free tasks phase, students used GenAI tools to generate outlines, compare them with their own analyses, and refine their essays through brainstorming, drafting, and peer review. Finally, in the evaluation phase, students presented their work in a mock conference and reflected critically on AI’s usefulness, limitations, and ethical implications while demonstrating ownership of their interpretations.

Ai Research Project: Rhetorical Analysis Of Llm Output, Laura M. Dumin

Teaching Repository of AI-Infused Learning

Students are asked to work in teams to look at the output from an LLM and to identify patterns in how language is used and information is being presented.

Misconceptions About Nursing In High School Students Of Color: Promoting Diversity In Nursing, Veronnica D. Pham

Doctor of Nursing Practice (DNP) Projects

Background: Equitable and culturally competent care can reduce health disparities among underserved populations; yet the nursing shortage the US faces does not allow for better patient outcomes. One barrier is how the profession can be negatively viewed among high school students of color.

Methods: A comprehensive literature search was performed to identify how perception of nursing affects a student’s career choice and what influences these perspectives. Three databases were utilized for this search: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus. Six articles were selected for this review. The following themes have been identified: misconceptions, …

Are We Leaving Donors Behind? An Evaluation Of Accessibility Of Higher Education Donor Webpages And Leadership Priorities, Lauren E. Baldwin

Electronic Theses & Dissertations

This study investigated the web accessibility and readability of U.S.-based nonprofit higher education institutions (HEIs) across the Foundation home, donation, and contact pages of selected websites. Utilizing a combination of manual verification and computer-automated analysis techniques, this study analyzes (n=101) institutional websites. Quantitative analysis reveals these webpages frequently contain WCAG 2.1 Level AA accessibility error types that are likely to affect the perceivability, operability, and understandability of the user’s experience, especially for individuals with disabilities or limited English proficiency. Further, these tests reveal significant differences by sector across multiple WCAG 2.1 Level AA accessibility error types, indicating that …

Suprasegmentals And Small Talk Skills: An Adult Esl/Efl Teacher Training And Curriculum Design, Katya Davida Landau

Master's Projects and Capstones

There is inadequate education and training for Adult ESL teachers on how to teach pronunciation, especially the essential suprasegmental feature of intonation. This leads to the perpetuated issue of lowered intelligibility amongst ESOL learners, which limits their opportunities in English-speaking settings. Through the provision of innovative curriculum and teacher training videos that share pedagogical content knowledge (PCK) on the subject of suprasegmental phonemes, these issues can be addressed.

Any curriculum developed to teach suprasegmentals must consider the role of creative and engaging activities to inspire learners, comprehensibility and intelligibility, embodied pronunciation techniques, and the impact of explicit, communicative, and task-based …

Chinese Intellectual Property Theft On United States Innovation In The Aerospace, Energy, And Pharmaceutical Economic Sectors Through Human Intelligence And Cyber Intelligence Collection, Preston Martz

Honors Theses

In cases of Chinese intellectual property theft on aerospace, energy, and pharmaceutical sectors in the United States, does Chinese intelligence collection favor HUMINT or CYBINT for collection? Sub questions also arise, including: to what extent does the amount of information collected vary by collection through HUMINT vs. CYBINT? Furthermore, does the sector where IP theft is used change the method of collection used? Finally, to what extend do case factors and outcomes affect the collection method used?

Showcasing Student Artwork In An Academic Library, Holly Gabriel, Jan Juliani

Collaborative Librarianship

In this paper, the collaborative efforts of a Government Documents Librarian, an Art Librarian, and an Emerging Media and Digital Arts Professor at a regional public university with a liberal arts focus are detailed. The collaborative project began as a way to celebrate the 70th anniversary of the university library's membership in the Federal Library Depository Program. The authors asked students in a graphic design class to each create a poster featuring a randomly assigned government agency to display in the library as part of the anniversary celebration. The professor and librarians framed the poster project as a real-world design …

Archivist, Subject Librarian, And Education Faculty Collaboration: Co-Instruction In History Of Education Classes, Laura Cameron, Kara Flynn

Collaborative Librarianship

In many academic libraries, primary source instruction happens in a vacuum, and students don’t always make connections between the skills they learn in a primary source instruction session and skills they may have already learned in information literacy-focused library instruction that they have participated in previous courses. This case study describes the design and objectives of an instructional partnership formed between an Education & Engagement Archivist, Education Librarian, and History of Education professor at a public, four-year university. The Education & Engagement Archivist and Education Librarian worked in tandem to develop interconnected lesson plans, allowing the Education & Engagement Archivist …

Enhancing Academic Efficiency Through Ability Grouping And Remedial Classes: The Cases Of India And Vietnam, Samwel Lwiza

Journal of Humanities and Social Sciences

Improving the performance of academically weak students remains a major challenge in developing countries, particularly in the context of the ‘leave no one behind’ agenda. This study examines the roles of ability grouping and remedial classes in enhancing academic efficiency among students in India and Vietnam. Drawing data from 17,866 students in the 2016/17 Young Lives School Survey, this study estimated efficiency scores by using the order-alpha partial frontier approach, and their determinants were assessed through a bootstrap truncated regression model. The findings indicate that ability grouping increases students’ efficiency by 3%, whereas remedial classes decrease it by the same …

Jmu Libraries Magazine: Volume 3, Jenne M. Klotz, Emily D. Blake, Kristen S. Shuyler

Faculty Scholarship

Volume 3 of the biennial JMU Libraries magazine, highlighting services, events, awards of the JMU Libraries.

The Diamond, December 12, 2025, Dordt University

Dordt Diamond

• Front Page: Dordt TPUSA Chapter Stuck in Approval Process; The Future of Christian Colleges in Light of Trinity's Closure; Hoyt Reinalda - A Life of Dedication and Improbability
• Feature: "Rivers in the Desert" - Dordt Student Releases Creation Care Podcast; The Dordt Barber Boom - Student Hair Cuts Surge; Dordt Places Second in Esteemed National Finance Competition; The Church and the Crescent - Understanding Islam; Student Visas - How Proposed Legislation May Affect International Students at Dordt; The Word Became Flesh - Music Department Presents "Historic" Choral Christmas Concert
• News: Celebrating the Retirement of Librarian Tricia Kok; …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

Generational Differences And Registered Nurses’ Intention To Leave An Organization, Mutabazi Sekimonyo

Walden Dissertations and Doctoral Studies

As baby boomers, Generation X, millennials, and Generation Z converge in healthcare settings, their distinct values and work styles influence organizational culture, communication, and collaboration, ultimately affecting patient care outcomes. This study was conducted to explore the impact of generational differences on registered nurses’ intentions to leave their organizations or the nursing profession. By examining how these generational differences shape nurses’ intentions to leave their organizations, the study can help to identify challenges and opportunities for healthcare leadership. Through an analysis of generational expectations and workforce dynamics, this research aimed to inform strategies for supporting retention, enhancing job satisfaction, and …