Digital Commons Network^™

Quality Improvement Project Fall Prevention Among Skilled Nursing Facility Residents Through Staff Education, Reena Mathew

Doctor of Nursing Practice Projects

Falls among older adults in Skilled Nursing Facilities (SNFs) remain a leading cause of injury, hospitalization, and decreased quality of life. Preventing these falls requires awareness and effective staff engagement. This Quality Improvement (QI) initiative is targeted to decrease fall rates in a 90-bed SNF by educating caregivers on the significance and practice of purposeful hourly rounding. The project helped to improve staff knowledge, consistency, and accountability in implementing hourly rounding as a preventive measure. A pre- and post-intervention design was utilized. Staff members received structured educational sessions based on evidence-based guidelines, including interactive modules and printed resources. Twenty staff …

Quality Improvement Project: Faculty Education On Clinical Evaluation Tool Utilization For Outcome-Based Assessment And Readiness In Clinical Competency Evaluation, Catherine Odom

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement initiative addressed the lack of consistency and subjectivity in clinical evaluations of nursing faculty at a community college in the southern United States. The intervention was a structured faculty development program spanning eight weeks, focusing on Objective Structured Clinical Examinations (OSCEs) and performance rubrics. The project was guided by the IOWA Model of Evidence-Based Practice and the Kotter Change Management Framework, aiming to boost faculty confidence and inter-rater reliability in clinical assessment. The PICOT question was whether a structured educational intervention would enhance self-reported faculty confidence in clinical assessments relative to no …

Quality Improvement Project Data At Risk: The Implications Of Inconsistent Nursing Documentation On Patient Care Interventions, Amber Jones

Doctor of Nursing Practice Projects

Accurate nursing documentation plays a vital role in ensuring high-quality patient care, yet inconsistencies remain a common challenge, particularly with preventive screenings like pediatric tobacco use. Research shows that when documentation is incomplete or incorrect, opportunities to identify and intervene with at-risk adolescents are often missed. This quality improvement project was developed to address a specific gap in documentation practices at a community health clinic, where staff often failed to consistently complete the pediatric tobacco screening tool. The goal of the project was to determine whether evidence-based education, combined with chart audits and feedback, could improve the consistency in which …

Quality Improvement Project Improving Advanced Practice Registered Nurse Self-Efficacy And Retention Through A Structured Mentorship Program, James Caleb Kent

Doctor of Nursing Practice Projects

High turnover among Advanced Practice Registered Nurses (APRNs) creates significant challenges for healthcare delivery, continuity of care, and organizational costs. Despite convincing evidence supporting the use of mentorship programs to improve job satisfaction and retention, structured mentor education remains underutilized in many outpatient settings. This quality improvement project assessed the impact of a structured mentor education program on APRN self-efficacy related to mentoring competence. A single-group, pre-post design was implemented in one primary care department. Six APRNs completed an evidence-based mentor education module. Self-efficacy was measured using the Mentor Competence Assessment (MCA) survey administered immediately before and after education. Paired …

Childhood Vaccination In Mozambique Pre- And Post-Covid-19 Pandemic, Remy Mwamba

Walden Dissertations and Doctoral Studies

In 2019, infectious diseases and other conditions claimed the lives of over 5 million children under 5. Global immunization coverage remains below prepandemic levels, leaving behind over 14 million zero-dose children in 2022, of whom 84% lived in low- and middle-income countries. This quantitative cross-sectional study aimed to examine, using two consecutive Demographic and Health Surveys, whether the most significant household characteristics and health service utilization risk factors associated with nonvaccination before the COVID-19 pandemic still hold postpandemic in Mozambique. Andersen's behavioral model of healthcare service utilization was the foundation for this investigation. The sample included N=2034 children aged 12-35 …

Educational Leaders’ Perceptions Of Disproportionality In The Identification Of Elementary Gifted Students, Vincent Corrigan

Walden Dissertations and Doctoral Studies

Despite years of research on best practices in gifted program identification, racially diverse, linguistically diverse, and socioeconomically disadvantaged student populations continue to be underrepresented in elementary gifted programs. Guided by Renzulli’s three-ring conception of giftedness and practical system for identifying gifted and talented students, the purpose of this qualitative study was to explore local educational leaders’ perceptions of disproportionality in the identification of students for elementary gifted programs in a large public school system in the Eastern United States. For this basic qualitative design, data were collected through semistructured interviews with 18 educational leaders from the local elementary principal population. …

The Place Speaks: Sacred & Artistic Genealogies Of Appalachia, The Reece Museum, East Tennessee State University

The Reece Museum Exhibition Publications

Jimmy Morrow was born March 6, 1955 in Raven Branch, a population area in rural Del Rio, Tennessee. His father, Albert Morrow, is remembered as a very devout man who raised his seven children in the church, and young Jimmy Morrow began preaching there when he was just six years old, soon after he received his first vision. Throughout his career, in which the Rev. Morrow was the founder and pastor of the Edwina Church of God in Jesus Christ’s Name, Morrow also preached at churches in Tennessee, Alabama, Georgia, South Carolina, and Kentucky. Alongside his work as a spiritual …

Rethinking Empowerment: Financial Self-Efficacy In First-Generation College Students, David Steadman

Masters Projects

Financial wellness difficulties have increasingly been found as a trend found amongst college students in research, as loans increase and student aid decreases, research is needed to understand new approaches to financial wellness and improving this problem within higher education. This project explores financial wellness and the need for wellness support amongst first-generation college students, as they continue to face unique wellness challenges in education at disparate rates. Specifically, it focuses on Financial Self-Efficacy (FSE) as a mediating factor of financial wellness, instead of a traditional focus on purely financial literacy. Grounded in Albert Bandura’s self-efficacy theory, the First-Generation Financial …

Assessing And Improving Provider Knowledge And Comfort With Palliative Care Consultations: A Quality Improvement Project, Summer R. Hess

Doctor of Nursing Practice Projects

Palliative care remains significantly underutilized in the management of heart failure, despite national guidelines supporting its early integration. This underuse limits opportunities for person-centered care in cardiology settings. The purpose of this quality improvement project was to improve provider knowledge and comfort in implementing palliative care consultations. The problem addressed was the low consultation rates for advanced heart failure patients, largely driven by provider misconceptions and a lack of formal training. A quasi-experimental design was initiated by using a brief, evidence-based educational article. Sixteen advanced practice providers at a high-volume cardiology clinic completed pre- and post-intervention surveys using the End-of-Life …

Quality Improvement Project Evaluation Of The Effectiveness Of The Institute For Healthcare Improvement’S Joy In Work Framework On Burnout Experienced By Dialysis Staff, Bernice Jones

Doctor of Nursing Practice Projects

Burnout continues to pose a pervasive and escalating challenge in healthcare, with its severity further amplified in the aftermath of the COVID-19 pandemic. Dialysis professionals are especially vulnerable, facing elevated patient volumes, extended work hours, and frequent encounters with complex clinical needs. These ongoing stressors highlight the critical importance of this quality improvement (QI) project, as there exists an urgent need for evidence-based strategies to alleviate burnout among dialysis professionals. This QI project aimed to enhance joy in the dialysis work setting and reduce burnout experienced by dialysis staff through the implementation of the Institute for Healthcare Improvement’s (IHI) Joy …

Development Of Policy Related To Test Anxiety In High-Stakes Environment, Jancy J. Sabu

Doctor of Nursing Practice Projects

Many nursing students experience test anxiety (TA) due to the highly stressful learning environment and the high-stakes nature of nursing exams. A community college in Texas has experienced an increase in student attrition from 2018 to 2022, primarily due to course failures, which are linked to TA. Expressive writing (EW) is a proven intervention that allows students to write about their anxieties and fears related to exams, helping them to regulate their emotions and manage TA. This project aimed to develop a policy that implements EW as an intervention and incorporates it into the nursing syllabus. Using the Centers for …

Dyadic And Multiparty Turn-Taking In Two Deaf Preschool Classrooms, Savannah Tellander

Theses

Conversational turn-taking skills are needed to succeed in most conversational interactions. Timing of turn-taking is crucial for young deaf signers, who need early, accessible, and consistent input in a signed and/or spoken language. For deaf children who acquire a language in either modality, they must acquire appropriate turn-taking skills. Without these abilities, children may miss critical language input, and in a cascading effect–they may miss opportunities both for input (and thus new knowledge) and expressive language. In addition to documenting deaf children’s turn-taking skills across development, it is important to also document timing data for further understanding of cognitive language …

The Impact Of The Implementation Of A Code Lavender Stress Management Program On Post-Surgical Critical Care Nurses’ Stress, Solange Ngoundjou

Student Scholarly Projects

Practice Problem: Post-surgical critical care nurses face a variety of stressful events when providing patient care. And there is a strong relationship between job stress, provision of patient care, patient satisfaction, and the overall well-being of the organization.

PICOT Question: For post-surgical critical nurses who are part of a stressful event (P), do evidence-based stress management strategies (I) compared to the current practice (C), reduce stress (O) within 8 weeks (T)?

Evidence: The evidence that guided this project change is based on John Hopkins’ nursing evidence-based practice model, and Lewin’s Change theory.

Intervention: The Code Lavender …

Staff Education To Enhance Nonmedical Staff Competency In Withdrawal Management, Katherine Hedrick

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a significant gap in staff training at a behavioral health residential treatment facility. Nonmedical staff, including substance abuse counselors, lacked formal education in recognizing, assessing, and escalating symptoms of substance withdrawal. This lack of competency posed a risk to patient safety, regulatory compliance, and quality of care. The goal of the project was to evaluate the impact of a structured, simulation-based training program on nonmedical staff’s knowledge and confidence in using validated withdrawal assessment tools and monitoring vital signs. Six nonmedical staff participated in the training, which incorporated lecture, hands-on simulation, and …

Effective Strategies For Mitigating Skills Gaps Postpandemic In The Automotive Industry, Neil Shah

Walden Dissertations and Doctoral Studies

Inadequate approaches to filling employee skill gaps can seriously weaken workforce stability and organizational performance. Canadian automotive sector leaders are concerned about the risk of persistent employment shortages, high employee turnover, and decreased productivity. Grounded in Alderfer's existence, relatedness, and growth theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the strategies employed by Canadian auto manufacturers to address skill shortages in their workforce in the wake of the pandemic and subsequent digitalization. Six senior executives from Canadian auto manufacturers who led successful skill-development and retention initiatives participated in semistructured interviews, complemented by a review of …

African American Men's Perceptions Of Law Enforcement, Dr. Dedrie Reshell Leonard-Francis

Walden Dissertations and Doctoral Studies

African American Black men are more likely to report unreasonable, unnecessary, and unwarranted experiences with U.S. law enforcement than men of other racial groups, and they higher mistrust toward law enforcement than any other racial group. These experiences have been described as unjustifiable due to the level of force used by police. In some cases, excessive force by law enforcement has resulted in the death of Black men. The purpose of this phenomenological study was to explore Black men’s perceptions of law enforcement and to understand their distrust. The study centered on the facilitators and barriers to Black men trusting …

Explicit Instruction’S Role In Phonemic Awareness And Phonics In Early Childhood Education, Sydney J. Fisher

Masters Projects

Research consistently demonstrated the impact that explicit instruction has on young children’s acquisition of phonemic awareness and phonics skills, critical foundations for later reading success. These skills are linked to achievement in reading in the upper elementary grades and beyond. Children reading below often face challenges across subject areas, and low literacy levels can limit meaningful participation in the community. This project examines research on developing phonemic awareness and phonics skills. With proper training and knowledge, teachers can improve student outcomes in these areas. However, teacher preparation programs and professional development does not adequately address these skills and how to …

Like A Scientist: A Method For Introducing Disciplinary Literacy In The Science Classroom, Elizabeth L. Kuperus

Masters Projects

To be literate within a particular area of study requires an understanding of the literary disciplinary norms practiced in that field. Within the science classroom, students are often expected to engage with scientific literature, yet are unable to fully grasp the material since they have not been taught the disciplinary literacies associated with science. This project evaluates research surrounding the area of scientific disciplinary literacy and suggests how it could be used to inform classroom instruction. Disciplinary literacy skills need to be explicitly taught and modeled to demonstrate how students can approach texts and other literacy practices as a scientist. …

The Need For Updated Curriculum, Krahseeva N. Hugmeyer-Walsh

Masters Projects

The modern world requires a workforce equipped with diverse, adaptable skills, yet many students remain unprepared due to outdated curriculum models that no longer align with current societal and professional demands. This project explores the growing disconnect between traditional educational systems and the skills needed in today’s fast-paced, technology-driven world. Current curricula often emphasize theoretical knowledge over practical application, leaving students ill-equipped to navigate real-world challenges. This project also proposes the development of a modernized secondary-level curriculum unit that prioritizes critical thinking, creativity, collaboration, ethics, and technological literacy. The proposed unit is designed to reflect student interests, promote engagement, and …

Exploring Parenting Students’ Experiences With Institutional Support Using The Loss/Momentum Framework, Paula Kwok Jung

LMU Theses and Dissertations

The California Community College system serves as the primary entry point for our marginalized student populations. According to Cruse et al. (2019), approximately 22% of nontraditional students in colleges and community colleges identify as student parents. Student parents are highly motivated to succeed in their academic journey. However, due to various factors including institutional barriers and the lack of support, it was found that only 37% of all parenting students complete a degree or certificate within six years, compared to 60% of non-parenting college students (Reed et al., 2021). Research has shown that institutional actions and support play a crucial …

Pica Syndromes And Iron Deficiency Anemia Treatment: A Mini Review, Humza Mallick, Samir Dalia

Student Publications

Background/Objectives: Pica, the compulsive ingestion of non-nutritive substances, has long been observed in patients with iron deficiency anemia (IDA). This behavior is particularly noted in adults, including pregnant women, and poses both diagnostic and management challenges. We conducted a review of studies from the past decade to evaluate the epidemiology and nature of pica in adult IDA patients and the outcome of various treatment strategies on anemia and pica behaviors. Methods: We searched PubMed, Scopus, and Cochrane Library for peer-reviewed articles (including observational studies, clinical trials, and reviews) published in English between 2015 and 2025. Inclusion criteria targeted studies of …

Maladjustment In Minority Youth From Community Network Disparities In The Covid-19 Lockdown Environment, Michael Okoronkwo, Aaron Mack, Keyana Varnado, Michael Alfred, Kevin Hardy, Amarachi Osuji, Percy Takyi, Gabriel I. Onor, Oluwatomi Akingbola, Rahn Bailey

Department of Medicine Faculty Papers

Pandemic lockdown orders resulted in closures to critical community networks. One such infrastructure was community recreation centers/parks. This infrastructure serves a critical role in building psychosocial wellness for youth. Socioeconomic minority youth face baseline disparity in center/park distribution and services. Youth recreation activity declined 50% as result of lockdown orders with corresponding decline in youth mental health status. Despite overall youth activity decline, White and high socioeconomic demographic categories were associated with greatest recreation access during the pandemic. Thus, the pandemic exacerbated preexisting disparities in recreation access for minority youth and its benefit towards adaptive development. Minority youth experienced greater …

Alternative To The Statistical Mass Confusion Of Testing For "No Effect", Josh L Morgan

2020-Current year OA Pubs

In cell biology, statistical analysis means testing the hypothesis that there was no effect. This weak form of hypothesis testing neglects effect size, is universally misinterpreted, and is disastrously prone to error when combined with high-throughput cell biology. The solution is for analysis of measurements to start and end with an interpretation of effect size. In this manuscript, I walk through some of the common critiques of significance testing and how they relate to experimental cell biology. I argue that careful consideration of effect size should be returned to its central position in the planning and discussion of cell biological …

Students' Social Attitudes Towards Students With Disabilities And Social Guidance In Inclusive Elementary Schools, Joko Yuwono, Ren Wenas, Nazmin Binti Abdullah, Mahardika Supratiwi, Fadjri Kirana Anggarani, Citra Tectona

Buletin Konseling Inovatif

Teachers in elementary schools have a strategic role in providing social guidance to students to accept the presence of Students with Disability (SwD). The aims of this study were to determine the social attitudes of students, how teachers provide social guidance for non-disability students regarding the presence of disabled students in class/school and describe the challenges faced by teachers. This study uses a mixed method approach (Quantitative and Qualitative). This research method uses a data collection technique, namely a questionnaire distributed via Google Form to teachers in Indonesia. Through the questionnaire, quantitative data (percentage) and qualitative data were obtained regarding …

I’D Rather (S)He Was Dead: Resurrection & Gender Transition In Superhero Comics, Jonathan Sexton, Eitan Runyan

Online Midwinter Seminar (OMS)

No abstract provided.

The Lay(Er)S Of The Corrigan, Lelie Brémont

Online Midwinter Seminar (OMS)

No abstract provided.

“Mysterium Tremendum Et Fascinans”: Melian’S And Lúthien’S Numinosity, Alexandra Filonenko

Online Midwinter Seminar (OMS)

No abstract provided.

Barriers To Participation In Follow-Up Services In Oncology, Casey Wagman

DNP Projects

Background
Psychological distress is often seen in cancer patients due to the physical, emotional, and social burdens of diagnosis and treatment. Patient participation in support services remains low despite the readily available psychosocial resources. The Emotional Well-Being Tool (EWBT), a validated psychological distress screening tool, is often used in a Midwest cancer clinic, yet it was noted that its supportive services were underutilized.

Purpose
This quality improvement project aimed to analyze the perspective of cancer patients on the EWBT, their understanding of its purpose and outcomes, and the perceived barriers to utilizing supportive services.

Methods
It was an exploratory design, …

The Use Of Debriefing To Combat Compassion Fatigue Among Cardiac Intensive Care Nurses, Brittany Johnson

DNP Projects

Background:
Compassion fatigue has physical, emotional, and psychological impacts on nurses working in intensive care units. Debriefing sessions can be used to help reduce compassion fatigue by allowing nurses on a cardiac intensive care unit to discuss their thoughts and feelings after the death of a patient who has had a complex hospital stay or traumatic death.

Aim:
The purpose of this project was to assess the perception of compassion fatigue on work life among Cardiovascular Intensive Care Unit (CVICU) nurses and to evaluate whether debriefing sessions following demanding situations enhance nurses' coping abilities and emotional processing.

Methods:
Nurses working …

Working Memory In Major Depressive Disorder: A Meta-Analysis Of Structural And Functional Brain Differences, Eunji Back

Master's Theses

Major depressive disorder (MDD) is one of the most prevalent mental health disorders in the US and is characterized by depressed mood and loss of interest. Many MDD patients also experience difficulties with executive function, including working memory. Neuroimaging studies reveal structural and functional brain differences between MDD patients and healthy controls that may underlie these working memory difficulties, but findings have been mixed. A quantitative synthesis of neuroimaging data through a meta-analytic approach offers a promising avenue to identify commonalities across studies. We conducted separate meta?analyses of structural and functional magnetic resonance imaging (MRI) data, with the latter focused …