Digital Commons Network^™

Enhancing Patient Safety In A Skilled Nursing Facility With A Post-Fall Huddle Protocol: A Quality Improvement Initiative, Evelin Yajaira Dominguez Dominguez

Master's Projects and Capstones

Objective To implement a post-fall huddle guide at a San Francisco Bay Area skilled nursing facility to address the 75 resident falls that occurred over an eight-month period. The literature emphasized the positive impact of huddles on staff communication, awareness, and collaboration which ultimately created a safe environment. Aim By November 4, 2025, the overall fall rates among patients in a San Francisco Bay Area SNF will decrease by 25%, from 4.8 falls per 1,000 patient days to 3.6 falls per 1,000 patient days. Methods Pre-implementation and post-implementation surveys were completed by LVNs and CNAs to assess knowledge of post-fall …

Beyond Compliance: How Targeted Education Improves Psychotropic Medication Documentation And Patient Safety In Skilled Nursing Facilities, Dyani Williams

Master's Projects and Capstones

Psychotropic medications are routinely prescribed in skilled nursing facilities to manage behavioral and psychological symptoms, but inadequate documentation poses risk to patient safety and leads to regulatory noncompliance. Objective: This project aimed to improve nursing staff knowledge and confidence in documenting psychotropic medication use in order to safeguard patient safety and follow Center for Medicare and Medicaid Services (CMS) guidelines. Aim: A targeted education session and standardized flowsheets were developed to enhance documentation adherence and staff confidence in psychotropic medication administration. Methods: To assess knowledge, comfort, and adherence to documentation standards a pre- and post-intervention survey were administered to nursing …

A Visual Nudge Toward Safer Skin: Reducing Hospital-Acquired Pressure Injuries (Hapi) At The Bedside, Iris Quach

Master's Projects and Capstones

Objective: With the increasing prevalence of hospital-acquired pressure injuries (HAPIs) among trauma patients at Highland Hospital, a quality improvement initiative was developed as a call to action. The overarching goal of this project was to design and implement a Quality Assurance and Performance Improvement (QAPI) intervention that was both feasible and cost-effective to address existing gaps and disparities during hospitalization at Highland Hospital, part of Alameda Health System in the Bay Area. Aim: The project aimed to evaluate whether a bedside visual cueing system could strengthen nursing compliance with pressure-injury prevention protocols and improve the consistency of communication among interdisciplinary …

Shattering The Silence: The Path To Maternal Equity In Texas, Karah Renfroe

The Scholar: St. Mary's Law Review on Race and Social Justice

The Black maternal mortality crisis reflects the persistence of institutionalized racism embedded in the U.S. healthcare system. In Texas, Black women account for just 11% of births yet represent 31% of maternal deaths—a mortality rate more than twice that of their white counterparts. This staggering disparity has persisted, even as statewide initiatives have improved maternal outcomes for non-Black women. This Comment situates the current crisis within a broader historical continuum: from the coerced medical experimentation on enslaved Black women by figures such as J. Marion Sims, through the codified racism of the Jim Crow era, to present-day inequities ingrained in …

The Evil Historical Twin: How The Requirement Of A Historical Analogy Could Result In Further Discrimination In The Law, Bryanna Mall

The Scholar: St. Mary's Law Review on Race and Social Justice

In 2024, the Supreme Court decided the case of United States v. Rahimi. The Court, unpersuaded by Rahimi’s objection regarding federal law which prohibited an individual subject to a domestic violence restraining order from possessing a firearm, decided the restriction was constitutional. While the holding of this case represents a win for survivors of domestic violence, the legal reasoning plants itself of flimsy concepts of history. The Court utilized a historical analysis test and looked to precedent rooted in social customs, legislation, and court holdings. The first major issue of this test is the dueling interpretation between a historical …

Process Intensification For Rare Earth Elements Adsorption By Resonant Vibratory Mixing (Rvm), Mehran Saddat

Graduate Theses & Non-Theses

Rare earth elements (REE) are crucial to the advancement of modern technologies. REE applications include electronics, defense systems, wind turbines, catalysts, magnets, and aircraft. Bastnasite, monazite, and xenotime are the primary resources, while the secondary resources, including coal ash, E-waste, and acid mine drainage, are for REE extraction. The primary processing techniques are chemical leaching, ion exchange, chemical precipitation, pyrometallurgy, solvent exchange, biosorption, and adsorption. Adsorption technique is simple, cost-effective, and environmentally friendly, with higher efficiency but at the cost of a longer mixing time. Therefore, there is a pressing need for an optimized mixing technique to improve the adsorption …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Standardizing The Use Of The Sinc Screening Tool In A Rural Clinic, Madison Foss

DNP Projects

Unmet contraceptive need represents a persistent quality gap in rural primary care, where reproductive health discussions are often inconsistently addressed. A rural primary care clinic in Shelbyville, Tennessee lacked a standardized, evidence-based process for screening women of childbearing age (15–44 years) for contraceptive needs. This quality improvement project evaluated the feasibility and effectiveness of implementing the Self-Identified Need for Contraception (SINC) screening tool to support routine, patient-centered care. The SINC tool consists of a single validated question designed to identify patients who wish to discuss contraception or pregnancy prevention during clinical visits. Plan–Do–Study–Act cycles were used to integrate the tool …

The Writing On The Wall, Haley Chiles

Undergraduate B.F.A. Theses in Studio Art

No abstract provided.

The Parables Of Gammalot, Celique Williams

Undergraduate B.F.A. Theses in Studio Art

No abstract provided.

Variation In Nectar Rewards Under Water Limitation Across Flowering Species, Madeline Isabelle Gregor

Undergraduate Honors Theses

Drought is becoming an increasingly dominant force shaping plant–pollinator interactions, yet we still know little about how nectar rewards respond to water limitation across species commonly used to support pollinators. We examined nectar volume and sucrose content in six flowering species relevant to California’s Mediterranean climate and quantified how drought alters these traits for four of those species. Under well-watered conditions, species differed in their nectar production, spanning more than two orders of magnitude. Perennial species such as Epilobium canum and Scrophularia californica produced the highest nectar volumes and sucrose amounts, suggesting that they contribute substantial carbohydrate resources when moisture …

Subculture And Identity As An Escape From The Societal Norms Of Power Imbalance And Authoritative Abuse, Sarah Goldberg

Master's Theses

By definition, a “bolthole” is an animal’s escape or burrow; or, a person’s escape or place of refuge. It also connotes construction, building, even sculpture - relating proletarian materials to themes of working-class labor and the need for escape. Through sculpture, installation, drawing, and oil painting, Bolthole as a body of work examines power imbalance as a societal norm, and identity and subculture as a rejection of the influence of capitalist institutions. Animal symbolism is used in combination with figurative work and portraiture, directly comparing power imbalances between humans to those in nature; such as predator and prey, parent and …

Effects Of Beach Renourishment On Sea Turtle Nesting Success, Caydence Pennington

Honors Theses

Beach geomorphology has a profound influence on nesting animals, particularly sea turtles, whose reproductive success depends on suitable sand conditions and stable shorelines. In many densely populated coastal regions, beach renourishment projects are implemented to combat erosion and protect infrastructure, yet these alterations can also affect sea turtle nesting ecology. This study evaluated the effects of beach renourishment on loggerhead sea turtle (Caretta caretta) nesting activity on Longboat Key, Florida, from 2021-2024. Nesting activity, hatch success, and depredation patterns were compared between nourished and reference beach zones to determine whether nourishment had an impact on these events. Nesting …

Developing An Ai-Assisted Grading System Using Large Language Models, Andrei Modiga

MS in Computer Science Project Reports

We present a grading system that accelerates evaluation of open-ended student work across scanned and digital workflows. The system crops answer regions from PDFs, assigns submissions via OCR on identity regions only, and groups answers by visual semantics using a vision LLM. Instructors review and edit groups, apply rubric items once per group, and export grades from an on-screen table. The solution integrates Ghostscript rasterization, PdfPig page orchestration, SkiaSharp region extraction, Tesseract identity OCR, and GPT-4o Vision for grouping. We detail the architecture, token-budgeted batching strategy, and persistence design, then describe testing results for grouping quality, time-on-task, and usability. The …

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

Collaborative Librarianship

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

How To Describe A Massacre? A Collaborative Metadata Justice Project, Bailey Hoffner, Eugene Albin, Jennifer Watson, Jay Shorten, Jacquelyn Slater Reese, Todd Fuller, Karie Antell

Collaborative Librarianship

Throughout the summer of 2020 and into the following fall, a cross-unit working group at the University of Oklahoma Libraries (OU Libraries) collaborated to compile and submit a proposal to change the Library of Congress Subject Heading (LCSH) Tulsa Race Riot, Tulsa, Okla., 1921 to Tulsa Race Massacre, Tulsa, Okla., 1921. The working group members situated this project in the context of the metadata justice movement, which seeks to correct problematic descriptions. They also see this proposal as part of the broader work undertaken over many decades by Tulsa activists and community leaders. This successful proposal required working group …

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

Collaborative Librarianship

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

The Interplay Of Morphology, Syntax, And Semantics In Kuria Verb Extensions Within The Mara Region, Mary Charwi

Journal of Humanities and Social Sciences

Verb extension morphological affixes that significantly alter verb meaning are a defining characteristic of Bantu languages. This paper investigates the morphosyntactic behaviour, semantic implications, and functional roles of extensions within Kuria, a Bantu language of Tanzania. The study adopts Hyman’s morphocentric approach, specifically the CARP template (Causative-Applicative-Reciprocal-Passive), as its foundational framework to test whether Kuria adheres to this pan-Bantu default ordering. The data were collected in Tarime District (2014-2015) using a mixed methods approach, comprising questionnaires, semi-structured interviews, and video stimuli with 13 rural and urban speakers, and text analysis (the Kuria Bible). Through rigorous morphosyntactic parsing, the analysis reveals …

The Experience Of Suicidal Ideation In Adults With Adhesive Arachnoiditis, Kathleen J. Haynes

Walden Dissertations and Doctoral Studies

Suicide is the 11th leading cause of death in the United States. Chronic pain has been linked to death by suicide, and a considerable amount of research has examined how conditions that produce chronic pain increase the risk of SI and suicide attempts. Adhesive arachnoiditis (AA) produces chronic, intense pain and has not been well-studied. It was thought to be a rare condition, but the number of cases has grown dramatically in recent years. The purpose of this interpretative phenomenological analysis (IPA) study was to explore the experience of SI in individuals with AA. The interpersonal theory of suicide was …

Learned Resiliency: Lived Experiences Of First Responders, Kevin Francis Sullivan

Walden Dissertations and Doctoral Studies

Scholarly literature has found that post-traumatic stress impacts first responders; however, little attention has been paid to how first responders learn resiliency through post-traumatic growth (PTG). The purpose of this hermeneutic phenomenological study was to explore a gap in the literature of first responders who learned resiliency through posttraumatic growth following a critical incident in the line of duty. The research study was grounded in Heidegger’s philosophy of hermeneutic phenomenology, guided by resiliency theory , and informed by post-traumatic growth theory. Seven first responders from multiple disciplines were invited to participate in semi-structured interviews designed to provide rich and reflective …

African American Small Business Success Strategies, Zena Foster

Walden Dissertations and Doctoral Studies

Abstract African American small businesses fail at disproportionately high rates, contributing to job losses, economic instability, and reduced wealth-building opportunities in underserved communities. African American entrepreneurs who fail to address strategic, operational, relational, financial, adaptive, and personal dimensions of business ownership increase the risk to the long-term sustainability of their businesses. Grounded in entrepreneurship theory and human capital theory, the purpose of this qualitative pragmatic inquiry was to explore effective strategies African American entrepreneurs in the southeastern United States employ to sustain their businesses beyond five years. The participants were six African American small business owners who had operated their …

Psychological Capital Of Hospital Nurses In The United States During And After The Covid-19 Pandemic, Mary Jean Erschen-Cooke

Walden Dissertations and Doctoral Studies

This study was conducted to explore lived experiences, perceptions, and associated meanings reported by nurses during the COVID-19 pandemic to determine what protected their well-being. A plethora of research focused on the negative impact of exhaustion, compassion fatigue, moral distress, and burnout; however, there was a gap in information regarding supports for emotional, mental, spiritual, and physical health, particularly among U.S. nurses. The foundational theory of psychological capital (PsyCap), focusing on the positive psychological traits of hope, self-efficacy, resilience, and optimism, grounded this investigation. A basic qualitative research design yielded rich data from semistructured interviews with 16 nurses working full …

Exploring Decision-Making Experiences Of Social Workers Completing Involuntary Commitment First Evaluations For Inpatient Psychiatric Treatment, Jesse Brooke Creech

Walden Dissertations and Doctoral Studies

An increasing focus on the recovery, rights, and autonomy of individuals with serious mental illnesses has led to ongoing debate regarding the practice and legal regulation of involuntary commitment (IVC). To ensure ethical and appropriate patient care throughout this complex process, more knowledge is needed about social workers’ decision-making process regarding the use of IVC. The purpose of this study was to investigate the decision-making processes associated with IVC for inpatient psychiatric treatment in North Carolina using the biomedical ethics framework. More specifically, the study addressed how licensed social workers describe their experiences and decision-making processes when determining whether to …

Program Outcome Evaluation Of A Flexibly Structured Individual Outpatient Program For Severe Obsessive Compulsive Disorder In A Private Practice Setting, Jason R. David

Doctoral Dissertations

The current study is a quantitative program evaluation of the effectiveness private practice for treating obsessive compulsive disorder while incorporating multiple validated components to reduce common barriers of treatment access. There were three outcomes used to evaluate the first being the reduction in symptom severity across treatment, the second being the length of time in treatment before reduction can be seen, and the third being the rates completing treatment as agreed by therapist and participant. The current study was able to complete analysis for the first and third research question, and unable to answer the second. The first and primary …

Staff Education To Impact Staff Knowledge Of Depression Screening In Primary Care, Nkeiruka Chinwendu Unaegbu

Walden Dissertations and Doctoral Studies

Summary This doctoral project was a staff education program designed to improve depression screening among patients in an adult primary care setting. The practice problem addressed was the lack of standardized depression screening that led to inconsistent detection, delayed diagnosis, and fragmented mental health care. A move to address the issue is critical in nursing practice since nurses play a central role in early identification, patient advocacy, and integration of behavioral health into primary care. The practice-focused question guiding the project was, Will implementing a nursing staff education program impact their knowledge of Clinical Practice Guideline (CPG) for depression screening …

A Rodent Model Of Enhanced Anticipation Of Positive Events: Sex-Specific Modifications In Cognitive Bias And Emotional Resilience, Sarah C. Hartvigsen, Megan Hooper, Olivia Harding, Evelyn Barringer, Aditya Narayanan, Brendan Crockett, Yulia Shatalov, Paean Luby, Braden Wixted, Molly Kent, Kelly Lambert

Psychology Faculty Publications

While it is known that chronic unpredictable stress and negative events adversely affect neurobiological outcomes, much less is known regarding the neurobiological impact of positive emotions such as chronic anticipation of appetitive events. From a translational perspective, an enhanced understanding of the impact of extended exposure to positive emotions may provide novel insights into effective non-pharmacological, behavior-based approaches to enhance mental resilience. Here, we investigate a novel rodent model of chronic Unpredictable Positive Event Response (UPER) training in male and female Long Evans rats to examine behavioral, neural, and endocrine effects of enhanced anticipation of positive events. Rats were exposed …

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

Faculty Scholarship

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

A Qualitative Exploration Of Patient And Clinician Needs And Preferences For A Physical Activity Intervention During Breast Cancer Chemotherapy, D Carolina Andrade, Loni Parrish, Courtney Harriss, Lindsay L Peterson, Ryan P Duncan, Jingqin Luo, Maura M Kepper, Christine Marx, Mary C Politi, Elizabeth A Salerno

2020-Current year OA Pubs

BACKGROUND: Early intervention with physical activity (PA) during active cancer treatment is critical for improved health outcomes, but often difficult to deliver. We assessed patients' and clinicians' needs and preferences for a PA intervention during chemotherapy via semi-structured interviews.

METHODS: We conducted virtual semi-structured interviews from May 2022 to May 2023 with patients with stage I-III breast cancer and oncology clinicians recruited from a Midwestern comprehensive cancer center and community settings. We identified themes using deductive and inductive thematic analysis informed by the Consolidated Framework for Implementation Research.

RESULTS: Patients (n = 16) were mostly White, non-Hispanic (93.8%) females (100%) …

In The Mouth Or In The Gut? Innovation Through Implementing Oral And Gastrointestinal Health Science In Chronic Pain Management, Jo Nijs, Burel R Goodin, Et Al.

2020-Current year OA Pubs

Recent scientific advances point towards an important role for oral and gastrointestinal health in people with chronic pain. Poor oral health (e.g., periodontitis, tooth loss) is observed in subgroups of the chronic pain population, including abdominal pain, low back pain, fibromyalgia, and rheumatoid arthritis. In addition to poor oral health, studies have also revealed altered intestinal microbiota compositions in various types of chronic pain, including people with chronic low back pain, knee osteoarthritis, visceral pain, fibromyalgia, tinnitus, and migraine. While overweight/obesity contributes to the likelihood of gut dysbiosis, normal-weight individuals with chronic pain also more often present with poor gut …

Evolutionarily Convergent Mechanism Of Formin Regulation Coordinates Actin Polymerization In Apicomplexan Parasites, Pengge Qian, Yong Fu, Jianwei Zeng, Michael J Naldrett, Rui Zhang, L David Sibley

2020-Current year OA Pubs

Apicomplexan parasites rely on actin-based motility for host cell invasion and for their dissemination. Although previous studies implicate formin 1 (FRM1) in governing this process in