Digital Commons Network^™

Improving Implementation Of The Cmqcc Obstetric Hemorrhage Risk Assessment Tool To Improve Maternal Hemorrhage Response And Outcomes, Emily Hobbs, Karla Beiswenger

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to …

Walking Through History: Designing A Byu Women's History Walking Tour, Reese M. Rugg

Undergraduate Honors Theses

This thesis appears in two parts. The first is an analysis where I present a brief literature review of women’s history and women in editing and publishing. I also discuss the creation process and methods of applying design principles to a copyfitted manuscript of a BYU women’s history walking tour. The second is the copyfit 176-page manuscript and book cover, created in InDesign and Photoshop.

This project represents a continuation of recent efforts to highlight women who have built BYU in a more equitable way. The purpose of this project is to highlight the discrepancies in women’s archival history and …

Genotypic Triggers: Exposing Pharmacogenomic Blind Spots Via Host-Specific Backdoors In Generative Antimicrobial Peptide Models, Doniyorkhon Obidov, Xiaolong Guo, Yonghui Li, Kaichen Yang

Michigan Tech Publications

Large Language Models (LLMs) have accelerated drug discovery, particularly in the automated design of antimicrobial peptides (AMPs). However, current validation pipelines for peptide generation models overlook historical precedents showing that certain drugs carry health risks predominantly for individuals with specific genetic profiles. In this paper, we demonstrate that such targeted health risks can be induced intentionally and at scale by manipulating models that generate peptide candidates. We introduce the Genotypic Trigger, a backdoor attack that shifts a model’s generative distribution toward peptides with elevated predicted immunogenicity risk, an adverse immune reaction, specifically for carriers of a tar- geted HLA allele, …

Aquatic Therapy And Its Impact On Perceived Caregiver Strain, Amanda J. Carter, Cynthia Haynes, Katherine O'Hara

Summer 2026 OTD Capstone Symposium

Children with Autism Spectrum Disorder (ASD) frequently experience sensory dysregulation that significantly impairs their participation in daily occupations and increases caregiver strain (Lawson et al., 2020; Passarello et al., 2022). Although aquatic therapy has shown promise in improving sensory processing, motor skills, and social participation, there is limited research examining its specific impact on the caregivers’ ability to provide support at home (Butzman et al., 2022; Caputo et al., 2018; Güeita-Rodríguez et al., 2021).

This study is a mixed-methods, quasi-experimental pre/post-design. This study sought to investigate the impact of six weeks of aquatic therapy intervention on sensory regulation and its …

Program Development: Integration Of Occupation In Adaptive Fitness, Havyn A. Isaac, Lakeisa Boykin

Summer 2026 OTD Capstone Symposium

This project was a program development and implementation of an adaptive fitness program for individuals with physical disabilities that integrates occupation. This was done to bridge the gap between adaptive fitness and occupational therapy and highlight the role of occupational therapy in adaptive fitness settings. A needs assessment and activity analysis were completed and used to develop the weekly sessions throughout implementation. The implementation phase was over 6 weeks, with 3 sessions a week. Each week had an occupational focus that was identified and broken down with the activity analysis. The program highlighted the role of occupational therapy in adaotive …

Evaluation Of Unconventional Bolus Materials For Radiation Therapy: A Study Of Sand, And Rice, Brooke Benson

Masters Projects

Abstract

Purpose: Research easily accessible substitutes for Superflab which conform better to the patient surface and are more conformal in an attempt to increase efficacy of bolus for clinical use.

Methods: For this experiment, sand and rice were measured based on Hounsfield units (HU) and relative electron density (RED) and placed into bags to be formed to a patient surface, securing their shape through the use of a vacuum sealer. After repeated CT scans with the chosen materials, plans were calculated on each scan followed by measurement of HU, air gap volume, bolus volume, and dosimetric parameters including monitor units …

Use Of Technology May Negatively Impact Learners, Dajsha A. Avery

Masters Projects

Integration of technology has changed classrooms vastly in the 21^st century. The research evaluates if the use of technology may negatively impact young learners. The Theory of Constructivism developed by Jean Piaget and Lev Vygotsky encourages the integration of technology in the classrooms because it allows the students to lead their educational journey. It is discovered that using technology allows students to be more engaged, self-paced and work on specific skills. Additionally, educational apps are helpful to build confidence and are an incentive for students while practicing skills. Yet, it is recommended to only allow up to 7 hours …

Belonging & Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia L. Hickman

Posters

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …

Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …

Kindergarten Teachers’ Challenges Embedding Play-Based Learning In A Standards-Based Curriculum, Anna Catalan

Walden Dissertations and Doctoral Studies

The problem addressed in this study was that kindergarten teachers in a Western United States elementary school were challenged by standards that have become heavily focused on teaching academic skills at a younger age, instead of teaching with developmentally appropriate practices that allow for play-based learning (PBL). Framed by Vygotsky’s theory of PBL, the purpose of this basic qualitative study was to explore what challenges local kindergarten teachers had when embedding PBL in a standards-based curriculum. Data were collected through 15 semistructured interviews with Kindergarten teachers who had at least 2 years' experience embedding PBL in instruction. Using thematic analysis …

Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso

Walden Dissertations and Doctoral Studies

The transition from student nurse to professional practice remains a vulnerable period marked by role ambiguity, stress, and early turnover. At a large medical center, the lack of a structured bridge between the final capstone experience and the residency program contributed to inconsistent onboarding, reduced confidence, and diminished resilience among new graduates. Addressing this gap is essential for strengthening retention, supporting workforce stability, and improving patient outcomes within nursing practice. An evidence‑based clinical practice guideline (CPG) outlining best‑practice recommendations for a new graduate transition program from capstone to residency was developed for the facility. The practice‑focused question asked whether the …

Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape

Walden Dissertations and Doctoral Studies

Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% …

Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa

Walden Dissertations and Doctoral Studies

Pressure injuries that patients develop while hospitalized continue to be a major safety concern in hospitals treating very sick patients. These wounds hurt, make infections more likely, keep people in the hospital longer, and increase expenses. On many units, the steps meant to stop these injuries, like checking each patient's risk level and turning patients regularly are not carried out the same way for everyone. Because of this inconsistency, some patients develop preventable pressure injuries. The purpose of this Doctor of Nursing Practice (DNP) project was to create a clinical practice guideline (CPG) for organized pressure injury prevention and to …

Prevention Of Hypotensive Adverse Events Utilizing Structured Home Blood Pressure Monitoring In Patients On Glp-1 Agonists, Alexandrya M. Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement intervention was to assess whether a structured home blood pressure (BP) monitoring program with weekly check-ins would help decrease hypotensive episodes and associated adverse events in patients who have lost weight after GLP-1 agonist initiation.

Background: This project was implemented in an outpatient multidisciplinary clinic in Houston Texas. 

Methodology: A total of 13 patients were ask to monitor their BP daily and keep a log. Weekly telephone calls were conducted to monitor the patients and collect the data for a period of eight weeks. Weekly BP logs, hypotensive symptoms, and any antihypertensive medication …

A Measeles Susceptibility Screening Strategy For Perinatal Women, Sandra N. Davidson

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to implement a standardized measles susceptibility screening strategy for perinatal patients at a large academic teaching hospital in Texas. The project aimed to improve provider compliance with routine measles immunity screening and laboratory ordering by integrating screening into existing prenatal workflows. Background: Measles remains a highly contagious disease, and ongoing outbreaks in Texas showed gaps in prenatal measles immunity screening. The absence of standardized screening increases the risk of missed opportunities to identify non-immune patients and provide appropriate follow-up. Methodology: Using the Plan-Do-Study-Act (PDSA) quality improvement model, provider education, electronic medical record (EMR) workflow …

S.A.S.B. Corp V. Johnson & Johnson Health Care Systems Inc

2026 Decisions

USDC for the District of New Jersey

Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala

Walden Dissertations and Doctoral Studies

Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …

The Exploration Of Pandemic Educational Equity Among Virginia Schools, James Edward Graves

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic intensified existing educational inequities among marginalized student populations, prompting unprecedented federal investments through the Coronavirus, Aid, Relief, and Economic Security (CARES) Act to support educational continuity. Existing literature findings consistently demonstrated that collaborative leadership, equitable resource allocation, family engagement, and community partnerships improved educational continuity, which reduced learning disparities during the COVID-19 pandemic. Despite substantial resource allocations, limited research has examined parent perceptions regarding the equity and effectiveness of CARES Act-supported educational interventions. The purpose of this generic qualitative study was to explore Virginia high school parents' perceptions of pandemic educational equity, CARES Act financial disbursement strategies, …

Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …

English Language Arts Remedial Teachers’ Perspectives On Strategies To Close The Academic Achievement Gap Of Minority High School Students, Barbara Williams

Walden Dissertations and Doctoral Studies

The problem that was addressed throughout this study is that 53% of minority students do not reach proficiency on the English Language Arts (ELA) portion of the Florida Assessment of Student Thinking test compared to the 42% of other student populations at Grover High School (GHS, a pseudonym), a large and diverse high school, despite targeted school improvement interventions each school year. Grounded in Ladson-Billings’s culturally relevant pedagogy, the purpose of this basic qualitative study was to investigate ELA remedial teachers’ perspectives on reading strategies and instructional planning tools that might help minority students close the academic achievement gap. Semistructured …

Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise

Walden Dissertations and Doctoral Studies

Delirium is a preventable and manageable neuropsychiatric condition characterized by acute fluctuations in attention, awareness, and cognition. The burden of this acute confusion syndrome among older adults aged > 65 years is disproportionate higher, due to age-related neurocognitive vulnerabilities. Nurse-led delirium prevention interventions can reduce incidence from 70% to 20% following structured education, gaps persist in nursing knowledge around evidence-based prevention strategies. The purpose of this project was to evaluate whether a structured nursing education intervention on enhanced mobility and sensory aid optimization strategies, as components of the ABCDEF bundle, improved nursing knowledge compared to standard care practices. Nineteen registered nurses …

Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …

Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger

Walden Dissertations and Doctoral Studies

Social determinants of health (SDOH) significantly influence health outcomes, yet many primary care organizations lack a standardized, evidence-based process for identifying patients' social needs and facilitating referrals to appropriate community resources. The purpose of this Doctor of Nursing Practice executive leadership project was to develop and implement a clinical practice guideline (CPG) to standardize SDOH screening and social services referrals in a primary care setting. The practice-focused question asked whether a CPG designed to standardize social services referrals would be approved by a panel of subject matter experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. …

Staff Education To Improve Evidence-Based Follow-Up For Patients With Severe Depression In An Outpatient Mental Health Clinic, Uzochiamaka Ndukwu

Walden Dissertations and Doctoral Studies

The practice gap addressed in this Doctor of Nursing Practice (DNP) staff education project was the inconsistent documentation completion of evidence-based depression follow-up actions for patients with severe depression in an outpatient mental health clinic. National clinical practice guidelines recommend that patients with clinically significant depression receive timely, documented follow-up that includes appropriate treatment planning, behavioral health follow-up, medication management when clinically indicated, and repeat symptom reassessment. However, baseline chart audit findings demonstrated variability in documentation of these evidence-based follow-up actions. The practice-focused question was: In an outpatient mental health clinic, does a standardized staff education program on evidence-based depression …

Exploring Licensed Clinical Social Workers’ Past Trauma And Current Practice: A Strengths-Based Perspective, Michael E. Conner

Walden Dissertations and Doctoral Studies

This qualitative study explored the lived experiences of licensed clinical social workers to examine how they manage, reinterpret, and integrate their childhood trauma into their professional clinical identities. Adverse childhood experiences among clinicians are often framed through a risk-based lens of burnout and impairment, leaving social work leaders without empirical models to support post-traumatic growth and workforce retention. The purpose of this study was to examine how clinicians leverage past adversity to inform contemporary practice. A basic qualitative design was used, with semistructured interviews conducted with 11 participants. Participant narratives were examined through the dual lenses of shattered assumptions theory …

Improving Outpatient Staff Job Satisfaction With Implementation Of Structured Educational Focus Groups Program: A Quality Improvement Project, Breanna Aromire

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to improve self-reported job satisfaction among outpatient pulmonary clinic staff through structured educational focus group sessions using iterative Plan-Do-Study-Act (PDSA) cycles.

Background

Job satisfaction among clinical staff is a key factor in retention, engagement, and quality of care. Outpatient specialty clinics often face workflow constraints that limit opportunities for structured professional development, which may negatively affect staff satisfaction. Educational and team-based interventions have been shown to improve workplace engagement.

Methodology

Six structured educational focus group sessions were conducted over three months, addressing key clinical and workflow topics. Two PDSA cycles guided real-time modification, …

Re: Approval Letter For Draft Final Silver Bow Creek Conservation Area (Sbcca) Butte Reduction Works (Brw) Air Monitoring For Interim Demolition Activities – Phase Ii Data Summary Report (Dsr) (Dated June 26, 2026), Emma Rott

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Exploring The Gaps And Opportunities For Development Of An Amr Educational Package For Higher Education. Project Dataset., Michael Dillon, Delphine Kayem, Thiru Vanniasinkam, Charlotte Cornbill, Muriel Dresen, Arya Gupta, Kristina Kadlec, Priyanka More, Afolake Atinuke Olanbiwoninu, Désirée Schaaf, Raju Sekar, Christina Stylianou

Faculty of Health Datasets

Anonymous cross-sectional survey of higher education educators worldwide teaching antimicrobial resistance (AMR) or related subjects. The dataset captures educators’ teaching experience, curriculum content, and resource needs to identify gaps in AMR education and support development of openly available teaching resources.

The Person As Foundation Of Responsibility: The Insufficiency Of Rights-Based Human Development Approaches, Jaclyn Berg

Electronic Theses and Dissertations

Building on the plethora of research that demonstrates the way rights language has been more useful for those with wealth and power to further expand capitalist markets, this text extends that criticism to human development programs and institutions. While they claim to be directed towards addressing global issues of poverty and hunger as well as climate crises, they continue to treat the symptoms without accurately diagnosing the disease. Approaches to development that rely on rights without questioning the way rights have been influenced by neoliberal capitalists or without questioning the capitalist global economic system will never be able to achieve …