Digital Commons Network^™

610 J.R. Mckelvey Tract 150 & 150a File, Deed Acquisition From The Mckelvey Private Land In The Rocky Mountain National Park, Box 106, George F. Ingalls, Hillory A. Solson, Wayne H. Hackett, David H. Canfield, Esther B. Mills, George G. Hondson

Rocky Mountain National Park

Document contains information about the purchase of the McKelvey private property in the Rocky Mountain National Park. There is a document that discusses the easement in placement around a water line on the property. Arno B. Cammerer; J. Russell McKelvey; Florance E. McKelvey; George F. Ingalls; W. W. Gratton; Enoa Mills; Endo Vally Campgrounds; Fall River; George M. McCaslin; Chester C. Brodie; Esther B. Mills; Minnie March Service; Hillary A. Solson; Charles A. Riley; Jackson E. Prase; Fall River; Wayne H. Hackett; Pipeline Easement; C. Marion Brafford; Esther B. Mills; Claire Noyes; Hotz's Claim; George Hodson; Fall River Lodge; Endovalley …

610-03 Harbison (Gudgel) See Also Kelley File #4 Box 46, Arno Cammerer, Joseph Taylor, A Van Dunn, G A. Moskey, Wayne Hackett, John Mclaughlin

Rocky Mountain National Park

Correspondence, legal documents, telegram concerning the selling of the lands belonging to Kate Harbison and Annie Hanson's land and water Rights.  Harison Ditch; Harbison Estate; Tonahutu Creek; Harbison Creek; Bob Harrison; Robert Harbison; Grand Lake Lodge; Roy Adams; Harbison Meadow; Mary Alice Schnoor; Kittie Harbison; Murnie Harbison;

Oh No, Don't Let The Rain Come Down..., Mervyn Bennun

Nebraska Journal on Advancing Justice

No abstract provided.

The Failure Of Law Reform: Housing Codes, Bans On Retaliatory Eviction, And The Implied Warranty Of Habitability, David Ray Papke

Nebraska Journal on Advancing Justice

No abstract provided.

Epidemiology Of Pompe Disease In Iraq, Noor Mohammed Saeed Dr., Akram Mohammed Al Mahdawi Dr.

Iraqi Postgraduate Medical Journal

BACKGROUND: Pompe disease is a rare, progressive, and autosomal recessive lysosomal storage disorder caused by mutations in the acid α-glucosidase gene. This study illustrates a survey of infantile and late-onset Pompe disease (IOPD and LOPD) in Iraq. We have contacted the pediatricians and neurologists at the hospitals to request a set of clinical and genetic data for patients with IOPD and LOPD. OBJECTIVE: To determine the epidemiological distribution of Pompe disease in Iraq. MATERIALS AND METHODS: The study was performed in Iraqi hospitals; patients enrolled between March to October 2023, included 44 patients, from infancy to late adulthood, diagnosed by …

Prevalence And Demographic Determinants Of Allergen Sensitisation In Iraqi Patients, Falah Hasan Hadi Dr., Mariam Amer Al-Ashbal Dr.

Iraqi Postgraduate Medical Journal

BACKGROUND: Allergen sensitisation patterns vary geographically and are influenced by demographic factors. Updated data from Iraq remains limited. OBJECTIVE: To determine the pattern and demographic determinants of allergen sensitisation among patients undergoing skin prick testing at an Iraqi allergy centre. PATIENTS AND METHODS: This cross-sectional study included 791 subjects aged 5–64 years who were referred to Al-Zahraa Centre for Consultation for allergy and asthma during 2023-2024. Saline dilutions of grass, mite, mould, tree and wood allergens were tested by allergy skin prick tests. Reactions were considered positive if the lab wheels had a diameter >3 mm. RESULTS: Overall, 73.6% of …

Thanking Strategies Across Relational Scenarios And Dyadic Gender Configurations In Urban Saudi Colloquial Arabic, Mohammed Ahmed Mohammed Alzahrani

Scientific Journal of King Faisal University: Humanities and Management Sciences

This study examines thanking strategies across three relational scenarios and four dyadic gender configurations among 120 university-educated urban Saudi colloquial Arabic speakers aged 20-40 from Riyadh, Jeddah, and Dammam. A scenario-based discourse completion task (DCT) yielded 720 responses comprising 1,843 strategy tokens; these data were supplemented by interviews with 30 participants. The intimate, acquaintance, and stranger scenarios differed in favor type and imposition, representing distinct relational-situational contexts. The DCT elicited contextually appropriate responses; accordingly, the findings are interpreted as reflecting participants' sociopragmatic preferences rather than naturally occurring interactional behavior. Expressing Benediction (30.1%) and Thanking (25.7%) were the two most frequent …

A Runtime Conditioning Architecture For Persistent Language-Model Identity, Ryan B. Pate, Ivan Anic

Defensive Publications Series

Language-model assistants fail in five ways that training-time alignment does not reach. They produce confident output that nothing supports. They drift toward agreement as a conversation warms. They lose the structure of what happened between sessions, not just the content. They either overclaim an identity or refuse to draw on the capacity they have. And asked to grade their own compliance with a rule, they confirm compliance whatever they actually did.

This disclosure describes a runtime conditioning layer directed at all five training alignment failures. It changes no weights, no training, and no model architecture: it works through documents loaded …

The Sport That Says Your Name: A Circulation Sport In Which Everyone Is Called By Another — Automated Name-Announced Receiver Selection With Equal Random Turn Distribution And Starting-Score Handicaps For Mixed-Ability Ball Games, Thon Ly

Defensive Publications Series

This disclosure describes a ball game in which an automated caller announces, before each strike, the name of the player who must receive next. Receivers are chosen by a shuffle bag: each round is a fresh random permutation of the roster, so every player receives equally often per round in an order players cannot anticipate. The sequence is a deterministic function of the roster and a seed declared before play, so anyone can recompute a session and verify the distribution; devices stay consistent by sharing only a call count, the round index persists across sessions, and no per-player record is …

Dual-Currency Reciprocity Infrastructure: Money And Time As Complementary Scarcities — A Platform Integrating Peer-To-Peer Money Gifts With Expiring, Non-Transferable Time Pledges Under A Bounded Ai Recommender, Thon Ly

Defensive Publications Series

A two-currency reciprocity platform integrates peer-to-peer money gifts with non-transferable, expiring pledges of personal time, under one user identity, one bounded AI recommendation agent and one shared participation indicator. On the time side, the AI agent recommends a time amount for each thank within a governance-set low/middle/high band; small pledges accumulate until a threshold activates a single redeemable commitment; an activated commitment lapses one month after activation if unredeemed; the recipient chooses the activity, and the giver may decline a specific request. A two-axis participation record (time delivered, time received) is disclosed in its original public form and in its …

The Bowl That Holds No Money: Steward-Routed Alms And The Bowl-Anchored Credential — Proximity-Verified Revocable Credential Tags For Routing Religious Donations To A Lay Steward Account, With Rotation Dispatch And Co-Presence Escrow Release, Thon Ly

Defensive Publications Series

We describe a donation-routing system for Buddhist monastic alms rounds in which a credential tag hung from a monk's alms bowl routes digital donations directly to a lay steward's account, so that money never enters monastic custody, as monastic rules require. The tag carries a revocable, time-limited credential issued by the monastic community and bound to the monk's ordination standing; a scan resolves the monk's name, monastery, current standing and the steward's account, resolves only in physical proximity to the tag (a copied image is inert), and stops resolving on loss of standing, giving donors a check against impostors when …

Special Education Teacher's Perceptions Of Genai For Creating Individualized Lesson Plans, Mahadevan Iyer

Dissertations

In the United States today, 7.3 million students are receiving special education (SPED) services under the Individuals with Disabilities Education Improvement Act (IDEIA, 2004). Rules and regulations governing SPED help ensure that SPED students receive good quality education. Section 1414(d) of IDEIA requires schools to provide specialized academic instruction as per each student’s Individualized Education Program (IEP). SPED teachers are responsible for accommodating, scaffolding, and individualizing the curriculum to meet the goals specified in the IEP. Defining the individualized curriculum is an added responsibility for a SPED teacher. This study examined SPED teachers’ access to instructional materials that implement EBPs …

Vision With Grace: Intersectionality Of Education And Spirituality, Preeti Jha

Dissertations

Contemporary educational leaders face increasingly complex challenges, systemic inequities, educator burnout, and demands for transformation, yet existing leadership frameworks fail to address the inner lives and spiritual practices that sustain such demanding justice work. While research demonstrates spirituality's role in leadership effectiveness, this dimension remains largely unexplored in educational research, particularly regarding how spiritual consciousness shapes daily practices and social justice engagement. This qualitative study will examine how spirituality shapes educational leadership and social justice engagement through portraiture methodology and in-depth interviews with three spiritually aligned educational leaders in Northern California. Drawing upon the Bhagavad Gita, Spiritual Leadership Theory, and …

Serials Spoken Here, Michelle E. Colquitt, Robert Hilliker, Jordan Claire, Jeremy Whitt, Taylor Ralph, Elizabeth Rapp, Alice Pearman, Megan Horn, Zachariah Motts, Joni Addis

Publications

This edition of “Serials Spoken Here” contains a wide variety of session recaps. Conference sessions from both national/international conferences as well as state/local sessions. Recaps from the ALA Annual Convention & Exhibition, Electronic Resources & Libraries (ER&L), UKSG, the Acquisitions Institute at Timberline Lodge, the American Association of Law Libraries, NISO Plus, ExLibris Users of North America (ELUNA), and the Academic Libraries of Indiana (ALI) Resource Rendezvous. Topics are arranged under the broad headings of Collection Management, Contracts & Agreements, Legal & Government Serials, Scholarly Integrity, Workflows, Metrics, and Discovery. The editors hope you will take something away from this …

การกำหนดนับอายุความหมิ่นประมาทออนไลน์: ศึกษาหลัก Single Publication Rule (Limitation Periods For Online Defamation: A Study Of The Single Publication Rule), Warut Songsujaritkul

Chulalongkorn University Law Journal

การเผยแพร่ข้อมูลบนสื่อออนไลน์มีลักษณะคงอยู่อย่างถาวรและสามารถเข้าถึงได้ตลอดเวลา เมื่อข้อความอันอาจเป็นการหมิ่นประมาทถูกเผยแพร่ผ่านแพลตฟอร์มดิจิทัล ปัญหาทางกฎหมายจึงเกิดขึ้นว่าควรเริ่มนับอายุความเมื่อใด เนื่องจากภายใต้หลักการเผยแพร่หลายครั้ง (Multiple Publication Rule) การเข้าถึงเนื้อหาแต่ละครั้งอาจถูกตีความว่าเป็นการกระทำความผิดใหม่ ส่งผลให้อายุความถูกขยายออกไปอย่างไม่มีที่สิ้นสุด ทำให้ผู้เผยแพร่ต้องเผชิญความเสี่ยงทางกฎหมายอย่างไม่มีกำหนด อันก่อให้เกิดผลกระทบเชิงยับยั้ง (chilling effect) ต่อเสรีภาพในการแสดงความคิดเห็น และเกิดความไม่สมดุลระหว่างเสรีภาพในการแสดงความคิดเห็นกับสิทธิในชื่อเสียงของบุคคล บทความวิจัยนี้ศึกษาวิเคราะห์มิติปัญหาทางกฎหมายว่าด้วยการกำหนดจุดเริ่มต้นการนับอายุความของความผิดฐานหมิ่นประมาทที่กระทำผ่านสื่อออนไลน์ โดยมีขอบเขตการศึกษาครอบคลุมถึงแนวคิดว่าด้วยการสร้างดุลยภาพระหว่างเสรีภาพในการแสดงความคิดเห็นกับการคุ้มครองชื่อเสียง การตรวจสอบหลักเกณฑ์การนับอายุความตามประมวลกฎหมายอาญาและประมวลกฎหมายแพ่งและพาณิชย์ของไทย และการศึกษาเปรียบเทียบพัฒนาการ บรรทัดฐานคำพิพากษา และบทบัญญัติทางกฎหมายของประเทศอังกฤษและสหรัฐอเมริกาที่นำหลัก Single Publication Rule มาปรับใช้ ผลการศึกษาพบว่า การปรับใช้หลักการนับอายุความแบบเดิมที่ถือว่าการเผยแพร่ซ้ำแต่ละครั้งเป็นความผิดใหม่ไม่สอดคล้องกับลักษณะของสื่อออนไลน์ และก่อให้เกิดภาระเกินสมควรแก่ผู้เผยแพร่ จึงควรนำหลัก Single Publication Rule มาใช้ โดยถือว่าการเผยแพร่เนื้อหาที่มีสาระสำคัญเดียวกันเป็นการกระทำเพียงครั้งเดียวและเริ่มนับอายุความนับแต่วันที่เผยแพร่ครั้งแรก เว้นแต่การเผยแพร่ครั้งหลังจะมีความแตกต่างอย่างมีนัยสำคัญจึงจะถือเป็นการเผยแพร่ใหม่ อย่างไรก็ดี การนำหลักดังกล่าวมาใช้ควรกำหนดรายละเอียดและกลไกทางกฎหมายเพิ่มเติม อาทิ การให้ดุลพินิจแก่ศาลในการขยายอายุความ การกำหนดขอบเขตระยะเวลาและการนับอายุความจากวันที่เผยแพร่ครั้งแรกให้ชัดเจน ตลอดจนมาตรการที่ใช้บังคับกับคลังข้อมูล แพลตฟอร์ม และผู้เผยแพร่ เพื่อสร้างความสมดุลระหว่างเสรีภาพในการแสดงความคิดเห็นกับสิทธิในชื่อเสียง ให้สอดคล้องกับบริบทของสังคมดิจิทัล

แนวทางการคุ้มครองสิทธิอนามัยเจริญพันธุ์สตรีและผู้ที่มีความหลากหลายทางเพศในบริบทของประเทศไทย (The Protection Of Reproductive Health Rights Of Women And Lgbtqian+ Persons In The Context Of Thailand), Chattrika Napatanapong, Nichakorn Khonthong

Chulalongkorn University Law Journal

บทความนี้มุ่งศึกษาถึงการคุ้มครองสิทธิอนามัยเจริญพันธุ์ของสตรีและผู้มีความหลากหลายทางเพศในบริบทประเทศไทย ภายใต้พันธกรณีระหว่างประเทศด้านสิทธิมนุษยชน เช่น อนุสัญญาว่าด้วยการขจัดการเลือกปฏิบัติต่อสตรีในทุกรูปแบบ (CEDAW) หลักการยอกยาการ์ตา และเป้าหมายการพัฒนาที่ยั่งยืนข้อที่ 5 ซึ่งต่างยืนยันถึงสิทธิในการเข้าถึงสุขภาพทางเพศและอนามัยเจริญพันธุ์อย่างเสมอภาคและปราศจากการเลือกปฏิบัติ จากการศึกษาพบว่า แม้ประเทศไทยจะมีความก้าวหน้าในเชิงกฎหมายและนโยบาย แต่ยังคงเผชิญอุปสรรคสำคัญ อาทิ อคติจากผู้ให้บริการ ความเหลื่อมล้ำทางเศรษฐกิจและภูมิศาสตร์ ตลอดจนข้อจำกัดทางกฎหมายที่ยังไม่สอดคล้องกับมาตรฐานสิทธิมนุษยชนสากล การศึกษาวิจัยนี้จึงมุ่งศึกษาพัฒนาการและปัญหาทางกฎหมายและนโยบายของประเทศไทยที่เกี่ยวข้อง เช่น การยุติการตั้งครรภ์ การขยายสิทธิประโยชน์ด้านการคุมกำเนิด การบริการอนามัยเจริญพันธุ์ รวมถึงสิทธิในการเข้าถึงบริการยาฮอร์โมนและการยืนยันเพศสภาพ โดยศึกษาเปรียบเทียบกับการคุ้มครองสิทธิอนามัยเจริญพันธุ์ในสหราชอาณาจักร เยอรมนี และอินเดีย อันเป็นตัวอย่างการพัฒนากลไกกฎหมายและนโยบายที่ช่วยลดความเหลื่อมล้ำและสร้างระบบบริการที่เป็นมิตร เพื่อยกระดับกลไกทางกฎหมายและนโยบายสาธารณะของไทยให้สามารถส่งเสริมและสนับสนุนสิทธิอนามัยเจริญพันธุ์เกิดขึ้นจริง ภายใต้พันธกรณีระหว่างประเทศด้านสิทธิมนุษยชน และบรรลุเป้าหมายการพัฒนาอย่างยั่งยืนได้ต่อไป

The Echo: September 29, 2025, Taylor University

2025-2026 (Volume 113)

No abstract provided.

Featured Archivist: Phillip Fitzsimmons, University Archivist And Special Collections Librarian, Southwestern Oklahoma State University, Scene Savers, Phillip Fitzsimmons

Faculty Articles & Research

"In 2007, as a newly minted librarian fresh from completing his Master of Library and Information Studies at the University of Oklahoma, taking every archiving class that was available at the time, Phillip was given a straightforward assignment: scan or photograph everything in a conference room and make it available online."

Primary Care Providers In Alabama And Washington Who Provide Care To African American Women With Dense Breast Tissue With And Without A Cancer Diagnosis, Andrea Shermaine Mcdaniel

Walden Dissertations and Doctoral Studies

African American women with dense breast tissue have experienced challenges related to breast cancer screening, timely follow-up care, and access to diagnostic services. There was limited research showing the experiences of primary care providers (PCPs) who provided care to this population. The purpose of this qualitative phenomenological study was to explore the lived experiences of PCPs in Alabama and Washington who provided care to African American women with dense breast tissue, both with and without a breast cancer diagnosis. The conceptual framework for this study was intersectionality theory, which is used to consider multiple social determinants of health when examining …

Associations Between Emotional Intelligence, Gender, And Situational Leadership Style Among Certified Public Accountant Firm Leaders In The Southeastern United States, Amber Holland

Walden Dissertations and Doctoral Studies

Emotional intelligence among certified public accountant (CPA) firm leaders is important for navigating demanding workloads, client pressures, workforce challenges, and complex interpersonal environments. Understanding factors associated with emotional intelligence may help senior CPA firm leaders strengthen leadership effectiveness and workforce stability. The purpose of this quantitative correlational research project was to examine the extent to which situational leadership behaviors and gender predicted emotional intelligence among CPA firm leaders in the southeastern United States. Emotional intelligence theory grounded the research project. Participants were 69 qualifying CPA firm leaders with at least 3 years of leadership experience. Data were collected through an …

Camouflaging Autistic Traits Is Not A Consequence Of Conformist Tendencies, Alastair Smith, Rhiannon Walsh

School of Psychology

Social camouflaging behaviours are often used by people with high autistic traits to negotiate a predominantly neurotypical social world. Previous discussion has associated camouflaging with a tendency to conform, although it has also been suggested that masking autistic tendencies may be a more specific motivating factor. The relationship between autistic traits and conformity is itself equivocal, suggesting that it may not necessarily be a driving force for social camouflaging in this group. To better characterise the relationship between these factors, we conducted an exploratory questionnaire study comprising measures of social conformity (Tendency to Conform Questionnaire), autistic traits (AQ), social camouflaging …

Impact Of Cannabis Use Screening And Early Intervention In Outpatient Psychiatric Settings, Theresa Chibuoke

Doctor of Nursing Practice Projects

Cannabis use can complicate psychiatric assessment, treatment planning, and clinical outcomes, yet standardized cannabis-use screening remains inconsistently implemented in behavioral health practice. This quality improvement (QI) project addressed inconsistent cannabis screening and referral practices in an outpatient psychiatric clinic by implementing a standardized workflow to improve screening documentation to at least 80% and timely referral completion to at least 75%. A quantitative, quasi-experimental pretest-posttest design included 10 outpatient psychiatric providers over six weeks. Lewin’s Unfreeze-Change-Refreeze model guided change, the Plan-Do-Study-Act framework supported implementation, and Donabedian’s Structure-Process-Outcome model guided the project. The evidence-based intervention incorporated provider education, the valid and reliable …

Quality Improvement Project: The Impact Of Provider Education On Antipsychotic Medication Side Effects, Anthony Emego

Doctor of Nursing Practice Projects

Weight gain is a frequent and clinically relevant side effect of antipsychotic medication. A needs assessment at the project site found that roughly 55% of patients on an antipsychotic treatment had clinically significant weight gain, and providers had no formal training on how to prevent and manage this. The purpose of this quality improvement project was to determine if a provider-focused educational intervention is effective in increasing provider confidence and decreasing antipsychotic-induced weight gain in adult psychiatric patients. This quantitative, one-group pre-post design utilized Lewin's Change Theory and Bandura's Social Cognitive Theory. It was conducted at an outpatient psychiatric clinic …

Quality Improvement Project: Improving Psychiatric Provider Confidence In Prescribing Long-Acting Injectable (Lai) Antipsychotics Through A Structured Education Program, Emile Bihnyuy

Doctor of Nursing Practice Projects

Schizophrenia is a disorder that affects about 24 million people globally and needs regular antipsychotic drug management to prevent relapse. Although long-acting injectable (LAI) antipsychotics are associated with better adherence to and fewer relapses than oral antipsychotics, their use is underutilized in outpatient psychiatric care. This quality improvement project aimed to increase psychiatric providers' confidence in the prescribing of LAIs by implementing a structured 12-week education program in an outpatient psychiatric clinic in Texas. The implementation was guided by the Iowa Model of Evidence-Based Practice and the change process informed by Lewin's Change Model. Four psychiatric providers completed the modified …

Quality Improvement Project: The Impact Of Proper Utilization Of Suicidal Ideation Screening Tools, Anuoluwapo Bode-Oloye

Doctor of Nursing Practice Projects

Suicide remains a significant public health concern, emphasizing the importance of consistent and evidence-based suicide risk assessment in outpatient mental health settings. The purpose of this Doctor of Nursing Practice quality improvement project was to determine how the provider’s implementation of the Columbia Suicide Severity Rating Scales (CSSRS) according to the recommendations of the Substance Abuse and Mental Health Services Administration would impact the confidence and the rate of completion of suicidal screening tools (Columbia Suicide Severity Rating Scales) compared to current clinic policy in an outpatient mental health clinic for over twelve weeks. This project used Lewin’s change model …

Quality Improvement Project: Improve Patient Show Rate For Appointments At The Outpatient Diabetic Clinic, Smitha Mathew

Doctor of Nursing Practice Projects

Missed appointments disrupt diabetes management, delay treatment, and waste healthcare resources. This quality improvement project evaluated whether patient-centered scheduling, staff education, and multimodal communication reduced no-show rates among adults with diabetes. The Plan-Do-Study-Act model provided the theoretical and implementation framework, while Kotter’s Eight-Step Change Model guided practice change. The uncontrolled preintervention-postintervention project occurred from January through July 2026 in a hospital-based outpatient diabetes clinic. The evidence-based intervention included 45-minute staff education, scheduling based on patients’ preferred days and times, verifying contact information and communication preferences, sending telephone and text reminders, and re-engaging patients the same day after missed appointments. Appointment …

The Impact Of Provider Education On Medication Adherence In An Outpatient Psychiatric Clinic: A Quality Improvement Project, Tina Ezeh

Doctor of Nursing Practice Projects

Medication adherence is important in psychiatric care, as nonadherence can contribute to poor health outcomes and increased use of healthcare services. A needs assessment at an outpatient psychiatric clinic identified inconsistent medication adherence education, with only 30% of providers routinely providing education and 20% using a structured approach. The purpose of this quality improvement project was to evaluate structured provider education, with the aim of assessing changes in provider confidence and the frequency of medication adherence education over eight weeks. Kotter’s 8-Step Change Model guided project implementation, while the Donabedian Model was used for project evaluation. A quantitative, one-group pretest-posttest …

Quality Improvement Project: Evaluating The Impact Of An Emotional Support Program For Nurses In A Rural Outpatient Clinic, Tosheta Brown Greenfield

Doctor of Nursing Practice Projects

Nurse burnout is a persistent, well-documented threat to workforce sustainability and patient safety, with rural nurses at heightened risk due to chronic understaffing, geographic isolation, and limited access to organizational support. The purpose of this quality improvement project was to implement and evaluate an eight-week Emotional Well-Being Support Program (EWSP), with the aim of reducing burnout and perceived stress among nurses working in a small rural primary care clinic. Guided by Lewin's Change Model and the Iowa Model of Evidence-Based Practice, the project used a quasi-experimental pre-test/post-test single-group design with four participating nurses. Burnout was measured using the Maslach Burnout …

Quality Improvement Project: Providing Evidence-Based Practice Education On Administering The Edinburgh Postnatal Depression Screening During Visits Once Per Trimester And Postpartum, Megan Keeney

Doctor of Nursing Practice Projects

Perinatal depression (PND) is prevalent worldwide and frequently remains undetected and untreated due to inconsistent screening. At the project site, the Edinburgh Postnatal Depression Scale (EPDS) was administered postpartum only, without standardization. This quality improvement project implemented evidence-based provider education and a revised EPDS protocol, screening once per trimester and postpartum, to increase PND identification, provider self-confidence, self-efficacy, and behavioral health referral rates. This project was guided by Lewin’s Change Theory and the Donabedian framework. A quantitative pre-post design was used with nine providers in an outpatient women’s health clinic, alongside a retrospective and post-implementation electronic health record (EHR) review. …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …