Digital Commons Network^™

Quality Improvement Project: Provider Knowledge Improvement For Care Of The Severely Hypertensive Obstetric Patient, Victoria Abramowitz

Doctor of Nursing Practice Projects

Gaps in confidence among emergency department (ED) and maternal child health services (MCHS) staff negatively impacts effectiveness and timeliness of response to high acuity obstetric emergencies, such as severe obstetric hypertension. The purpose of this quality improvement project was to evaluate the impact on provider self-efficacy with the implementation of evidence-based education and standardized procedures for severe obstetric hypertension management, aimed at evaluating the degree of success of increasing provider confidence. The project was guided by Lewin’s change theory and Donabedian’s structure-process-outcome theoretical framework. With a quasi-experimental design and the PDSA implementation framework, 20 staff from both the ED and …

Quality Improvement Project: Impact Of National Culturally And Linguistically Appropriate Services (Clas) Standards Education On Behavioral Health Providers’ Self-Efficacy, Zita Anigbou

Doctor of Nursing Practice Projects

Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners …

Implementation Of A Standardized Suicide Risk Screening Protocol Using The Columbia-Suicide Severity Rating Scale (C-Ssrs) In An Outpatient Mental Health Clinic, Kemisola Ebietomiye

Doctor of Nursing Practice Projects

The outpatient mental health clinics across the United States lack consistent suicide risk assessment methods. This project developed standardized procedures which used Columbia-Suicide Severity Rating Scale (C-SSRS) assessment together with provider education and electronic health record systems to evaluate how these elements impacted provider self-efficacy and their ability to record screening results. The project used a pre-post design to examine (n=24) psychiatric providers at an urban outpatient clinic through the combined methods of Lewin's Change Theory and the Plan-Do-Study-Act framework. The General Self-Efficacy Scale measured provider self-efficacy, and structured EHR audits tracked documentation rates pre- and post-implementation over six weeks. …

Quality Improvement Project: Empowering Nurses And Medical Assistants To Improve Medication Adherence: A Screening-Based Quality Improvement Initiative, Maria Garcia

Doctor of Nursing Practice Projects

Medication nonadherence is a persistent challenge in clinical settings that negatively influences patient outcomes and is often driven by cost, access, and patient-related barriers, as widely documented in the literature. Nurses and medical assistants play a critical role in identifying these barriers; however, inconsistent screening and limited staff confidence may hinder intervention. The purpose of this quality improvement project was to evaluate the impact of implementing the Brief Medication Questionnaire (BMQ) on staff confidence in addressing medication adherence and to assess clinic-wide utilization of the tool. The project was guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change …

Quality Improvement Project Standardizing Simulation In Nursing Education: A Faculty Training Initiative, Andrea Reyes

Doctor of Nursing Practice Projects

Simulation-based education is essential in nursing programs as clinical placement opportunities decline. However, inconsistent faculty preparation can compromise the quality of simulation delivery. The purpose of this quality improvement project was to implement and evaluate a standardized simulation faculty training initiative to determine its impact on nursing faculty's confidence in simulation facilitation. Guided by the Jeffries Simulation Framework and Lewin’s Change Theory, a quasi-experimental pre-post design was used to examine changes in faculty confidence following participation in a training program aligned with national standards and guidelines. Faculty confidence was measured using the Simulation Educator Needs Assessment Tool (SENAT) administered pre- …

Improving Diabetes Care: Staff Training On Updated Ada Guidelines, Jeffrey Wilson

Doctor of Nursing Practice Projects

The incidence of diabetes is rising, requiring clinical staff to stay current with the American Diabetes Association (ADA) Standards of Care. A lack of knowledge and outdated practices were revealed during the needs assessment at the project site. This quality improvement (QI) project sought to determine whether ADA‑centered educational training could impact staff members' knowledge of diabetes. Orem’s Self‑Care Deficit Nursing Theory and Lewin’s Change Theory served as the theoretical frameworks to promote provider competence and adherence to evidence‑based diabetes treatment. Quasi‑experimental pre–post design was used with a convenience sample of four clinical staff at a rural outpatient clinic. Study …

Quality Improvement Project: Protecting Young Kidneys: Optimizing Albuminuria Management In Youth With Diabetes, Mili Vakharia

Doctor of Nursing Practice Projects

Diabetic nephropathy is a major microvascular complication and the leading cause of chronic kidney disease (CKD) among individuals with diabetes. Children and adolescents with type 1 and type 2 diabetes face a higher risk of developing CKD earlier in life due to longer disease duration, poor glycemic control, and delayed CKD diagnosis. Guidelines emphasize timely detection and intervention to slow disease progression. Albuminuria is an early marker of glomerular injury and signals the need to initiate CKD treatment. Despite evidence supporting early detection and treatment, standardized management of albuminuria in pediatric diabetes care remains inconsistent. This Doctor of Nursing Practice …

Quality Improvement Project: Use Of The Behavioral Risk Assessment Tool To Enhance The Utilization Of The Behavioral Emergency Response Team, Joseph Sindhu

Doctor of Nursing Practice Projects

Workplace violence is a global challenge, and nurses often encounter patient aggression. The purpose of this quality improvement project was to enhance the use of a behavioral assessment tool derived from the Brøset Violence Checklist and the Behavioral Emergency Response Team (BERT) to de-escalate workplace violence. This project aimed to improve behavioral assessment documentation and BERT use in a critical care unit by 30% within 5 weeks. Guided by the Donabedian Model theoretical framework and Lewin's Change Theory, the project employed a quasi-experimental, pretest-posttest design in an advanced heart failure unit with full-time nurses as participants. The Plan-Do-Study-Act (PDSA) framework …

Standardizing Patient-Centered And Trauma-Informed Communication Practices Among Staff In A Behavioral Health Setting, Jayla Brown

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate the effect of an evidence-based educational intervention on staff attitudes toward trauma-informed and patient-centered communication in an outpatient behavioral health clinic. Guided by Lewin’s Change Theory and Jean Watson’s Theory of Human Caring, the project aimed to improve staff knowledge, attitudes, and confidence in applying trauma-informed communication strategies across all clinic roles. An eight-week educational intervention based on the SAMHSA Trauma-Informed Care Toolkit was implemented for clinical and administrative staff. A quantitative pretest–posttest quasi-experimental design was used, with outcomes measured using an adapted Attitudes Related to Trauma-Informed Care scale. All …

An Examination Of Trends And Factors Influencing Teen Retention In 4-H Youth Development Program: A Case Study, Bethany R. Corona

LSU Master's Theses

Teen participation in 4-H has declined nationally in recent years, raising concerns about long-term program sustainability and youth engagement. Understanding the factors that influence teens’ decisions to remain involved in 4-H is critical for informing program design and delivery. Guided by the theory of planned behavior, this qualitative study explored teen perceptions of 4-H programming, youth voice, social influences, communication, and barriers to participation. Data were collected through two group interviews with teen 4-H members representing multiple parishes. Interviews were audio recorded, transcribed verbatim, and analyzed using the constant comparative method through a three-phase coding process consisting of open, axial, …

Uas Path Planning With Dynamic Rerouting Using A Space-Time Graph, Kimoy Williams

Electronic Theses and Dissertations

UAS systems have emerged as multifaceted technologies with applications across a wide range of sectors. Their ability to access areas that are difficult or unsafe for manned systems has made them invaluable tools in various domains. As a result, UAS have transformed numerous industries, including infrastructure inspection, delivery and logistics, military and defense, as well as precision agriculture and environmental monitoring.

The advancement in UAS technology is fundamentally reliant upon ongoing research efforts in the specialized area of UAS path planning. Optimal flight planning is essential for a UAV to effectively execute its mission’s task safely, effectively, and in congruence …

Committee Opposition To Debtor's Motion For Claims Objection Procedures On Behalf Of The Official Committee Of Unsecured Creditors

Catholic Dioceses in Bankruptcy

No abstract provided.

Giant Cell Tumor Of The Tendon Sheath To The Lesser Digit: A Rare Presentation, Eyad Xoubi, Jehanzab Siddiqui

Advocate GME

No abstract provided.

Estimating The Baseline Age When Longitudinal Changes In Biomarkers Accelerate: Application To An Imaging Study Of Preclinical Alzheimer Disease, Chengjie Xiong, Folasade Agboola, Jingqin Luo

2020-Current year OA Pubs

BACKGROUND: Biomarkers are routinely measured from human biospecimens and imaging scans in Alzheimer disease (AD) research. Age is a well-known risk factor for AD. Detecting the baseline age at which the longitudinal change in biomarkers starts to accelerate is important to design preventive interventions. METHODS: We analyzed longitudinal biomarker data by a random intercept and random slope model where the slope (longitudinal rate of change) was modeled as a piecewise linear and continuous function of baseline age. We proposed to estimate the baseline age at the intersection of the two linear functions by multiple methods: maximum (profile) likelihood, minimum squared …

Applying Frame-Is To Characterize Provider-Led Adaptations To A Cervical Cancer Prevention Intervention In Kenya, Harriet Fridah Adhiambo, Katherine Thomas, Megan M Coe, Lynda Oluoch, Valary Ihaji, Mary Bernadette Kerubo, Alex Kinyua, Sarah Njoroge, Kenneth Ngure, Michelle Shin, Thomas A Odeny, Bryan Weiner, Nelly Mugo, Sarah Gimbel

2020-Current year OA Pubs

BACKGROUND: Implementation strategies that are contextually refined are essential for optimizing the delivery of evidence-based interventions (EBI) to prevent cervical cancer in low-resource settings. This paper reports the application of the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) to capture and disseminate strategy adaptations made to a single-visit, screen-and-treat approach with thermal ablation (SV-SAT + TA) strategy aimed at establishing sustainable cervical cancer prevention services in Kenya.

METHODS: A FRAME-IS-based tracking spreadsheet was developed to document bundled site-specific implementation strategy adaptations and across 10 facilities. Data was collected during technical assistants' (TAs) site visits, phone calls, …

Ketogenic Diet Dampens Excitatory Neurotransmission By Shrinking Synaptic Vesicle Pools, Marion I Stunault, Pan-Yue Deng, Anjali Yadav, Erica M Periandri, Francisca N De Luna Vitorino, Michael B Thomsen, Jasmin Sponagel, Amelia J Barfield, Renzelle J Ponce, Layla Foroughi, Benjamin A Garcia, Gabor Egervari, Vitaly A Klyachko, Ghazaleh Ashrafi

2020-Current year OA Pubs

Ketogenic diet (KD) is used for the treatment of drug-resistant childhood epilepsy and has been proposed to improve outcomes in neurodegenerative diseases. However, the mechanisms by which KD alters brain circuitry remain unclear. Here, we investigated the impact of KD on hippocampal function through integrative analysis of gene expression and neurotransmission. We found that KD induces extensive transcriptional reprogramming, including altered expression of numerous synaptic genes. Proteomic and genomic profiling revealed significant changes in histone modifications, particularly at promoters of KD-regulated genes. Electrophysiological recordings showed that KD reduces excitatory synaptic gain and short-term plasticity at CA3-CA1 synapses, dampening the summation …

Regional Brain Age Is Decreased In Children With Sickle Cell Anemia, Amy E Mirro, Landon C Power, Jinli Wang, Paula Germino-Watnick, Heather Roberts, Yonca Cam, Kristin P Guilliams, Slim Fellah, Yasheng Chen, Hongyu An, Jin-Moo Lee, Andria L Ford, Melanie E Fields

2020-Current year OA Pubs

DeepBrainNet, a machine learning tool, uses magnetic resonance imaging (MRI) to predict an individual's brain age, allowing calculation of the brain age gap (predicted chronological age) for use as a biomarker of brain health. We tested the DeepBrainNet tool in sickle cell anemia (SCA) on 210 brain MRIs from 130 children (90 with SCA; 40 healthy controls) to investigate the hypothesis that children with SCA would have a younger predicted brain age than healthy controls as an index of aberrant brain development. DeepBrainNet estimates brain age from 80 axial slices of each brain, with the median used as global brain …

Effective Strategies For Small And Mid-Sized Enterprises To Leverage Resources And Sustain Operations, Priscilla Neri Rebibis Barbero

Walden Dissertations and Doctoral Studies

Ineffective strategies for leveraging resources can lead to early business closures. Small-to medium-sized enterprise (SME) owners who struggle to acquire sufficient resources for their operations may experience diminished profits and business instability as a result. Grounded in resource-based view (RBV) theory, the purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies used by SME owners to leverage resources and sustain business operations beyond 5 years. The participants were 10 SME owners who had implemented strategies for sustainable business operations. Data were collected through semistructured interviews and a review of relevant public documents. Using thematic …

Secondary Syphilis Case Report: Septic Arthritis And Tendinopathy, Phil Kulpinski

Advocate GME

No abstract provided.

Academic Senate - Agenda, 02/24/2026, Academic Senate

Academic Senate Agendas

No abstract provided.

Limitations Of Genetic Testing, Tony N. Jelsma

Faculty Work Comprehensive List

"Knowing about a pathogenic variant may sharpen our awareness of our mortality, but it should not fundamentally change our perspective on life."

Posting about the advantages and disadvantages of genetic screening from In All Things, an online hub that offers insight into maintaining and faithful and orthodox Reformed Christian worldview while fearlessly engaging in every aspect of contemporary life – until all is made new.

Limitations of Genetic Testing

Prevalence And Predictors Of Inappropriate Antibiotic Prescriptions Among Dentists In Muscat Governorate, Oman, Wajiha Abdul Majeed Al-Lawati, Manar Alsanaa Ali Alzeedi, Elham Mohammadi, Noora Alhosni

Sultan Qaboos University Medical Journal

Objectives: Inappropriate antibiotic prescriptions represent a major healthcare concern, contributing to increasing antimicrobial resistance. Dentists account for up to 10% of antibiotic prescriptions, highlighting the need for rational prescribing practices. This study aimed to assess the prevalence and predictors of inappropriate antibiotic prescriptions by dentists in primary health clinics in Muscat Governorate, Oman. Methods: This retrospective cross-sectional study was conducted on dental antibiotic prescriptions issued between July and December 2024 in government and private dental care facilities across Muscat Governorate. Clinics were randomly selected and data were extracted from electronic patient records using a structured form. Descriptive statistics, Chi-square tests …

Opioid Use Knowledge And Attitudes Among U.S. Adults, Jadyn E. Knox

Master's Theses

The opioid epidemic remains a public health crisis, with overdose rates continuing to rise. Associations between individuals opioid use and knowledge of and attitudes toward opioid substances and overdoses have been investigated to inform educational interventions. However, many studies utilize college student or adolescent samples, and findings remain inconclusive. An assessment of opioid knowledge and attitudes across broader adult populations is lacking. Concurrently, replication literature in the social sciences is limited, therefore, the present study replicated and expanded upon Williams et al. (2013) and Vyas et al. (2023) studies. Reliability and validity of the Opioid Knowledge scale, Opioid Overdose Knowledge …

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Nursing Education & Burnout: Secondary Analysis Of Nssrn, Bridget M. Webb, Jennifer Mallow

Creating Healthy Work Environments (CHWE)

Background: Burnout is a risk factor for nurse turnover and intent to leave. Burnout impacts nurse outcomes including incivility, fatigue, and decreased self-esteem, while patient outcomes are adversely impacted as well, including increased mortality, hospitalizations, and emergency department visits. The level of nursing education could impact nursing burnout and turnover.

Purpose: To examine the differences in self-reported burnout and level of education related to nurses:1) leaving their primary nursing position, 2) intent to leave primary position, 3) not working in nursing, and 4) employment change in the National Sample Survey of Registered Nurses (NSSRN).

Methods: The 2018 (pre-pandemic) NSSRN data …

Quality Improvement Project: Improving Pneumococcal Vaccination Rates Through Provider Education In Primary Care, Leikasha Allen

Doctor of Nursing Practice Projects

Pneumococcal disease remains a major cause of illness and mortality among adults aged 65 years and older, leading to severe pneumonia, bacteremia, and meningitis, particularly in vulnerable populations. Although effective vaccines and clear Centers for Disease Control (CDC) and Advisory Committee Immunization Practice (ACIP) guidelines, vaccination in this age group remains inadequate. This Doctor of Nursing Practice (DNP) quality improvement project aimed to determine the impact of pneumococcal vaccination compliance through evaluating provider knowledge, confidence, and adherence to evidence-based guidelines through targeted education. Guided by Rogers’ Diffusion of Innovation Theory and the Health Belief Model, a 20-minute evidence‑based educational session …

Implementation Of A Mentoring Toolkit: A Quality Improvement Project, Joshlyn Neu

Doctor of Nursing Practice Projects

Nursing faculty mentorship is an essential component of professional development, job satisfaction and faculty retention. However, many schools lack a structured approach to preparing their faculty members to act as mentors. This quality improvement project set out to determine whether the implementation of a formal mentoring toolkit would improve nursing faculty members perceived competency to act as mentors. Guided by Bandura’s Social Cognitive Theory (SCT), Lewin’s Change Theory, and the latest evidence-based research, this project sought to answer the following question: In full-time nursing faculty members teaching in a BSN program at a small, private college (P), how does the …

Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background

Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.

Methods

Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …

Staff Education To Improve Psychiatric Nurses’ Use Of Evidence-Based Strategies For Supporting Medication Adherence In Outpatient Settings, Lilian Ndifon

Walden Dissertations and Doctoral Studies

Psychiatric medication nonadherence remains a persistent barrier to effective outpatient mental health care and contributes to relapse, rehospitalization, and disrupted continuity of care. In outpatient psychiatric settings, nurses are often responsible for patient education and follow-up, yet many lack formal training in evidence-based strategies to support medication adherence. This staff education project was implemented at an outpatient psychiatric facility to address this practice gap. The practice-focused question asked whether a structured staff education intervention would improve outpatient psychiatric nurses’ knowledge of evidence-based medication adherence strategies. Twelve outpatient psychiatric nurses participated in a one-hour educational session focused on motivational interviewing, psychoeducation, …

Strategies To Reduce Prolonged Emergency Department Length Of Stay And Improve Outcomes For Elderly Patients, Shameeka Shonta Mcduffie

Walden Dissertations and Doctoral Studies

Prolonged emergency department (ED) length of stay (LOS) among elderly patients is a complex and escalating challenge that calls for immediate strategic action from healthcare administrators seeking to improve outcomes and system efficiency. The purpose of this integrative review is to identify evidence-based strategies to optimize emergency department quality of care for elderly patients in acute hospital settings by examining systemic, clinical, and operational contributors to extended ED stays. A comprehensive review of literature published between 2021 and 2025 was conducted using systematic search and appraisal methods. Findings from the 12 peer-reviewed studies included in the final analysis were appraised …