Digital Commons Network^™

Changing The Paradigm For Newly Graduated Nurses’ Intent To Leave Through An Emeritus Rn Virtual Mentoring Program In An Acute Care Hospital Setting, Lacy Eynon

Yale School of Nursing Digital Theses

The U.S. nursing shortage presents a critical challenge to healthcare organizations, withwide-reaching implications for patient safety and financial sustainability. High nurse turnover contributes to increased staffing costs, estimated at $56,300 average cost per nurse replaced. This shortage directly impacts patient outcomes including increased rates of medical errors, patient mortality and decreased overall quality of care. Supporting early-career nurses through mentorship programs is a promising strategy to improve professional development and retention, thereby addressing clinical and economic consequences workforce shortages. This DNP Project developed and implemented an Emeritus RN Virtual Mentoring Program utilizing experienced emeritus nurses to mentor nurses with less …

Readmission Reduction Of 1st Year Transplant Recipients, Kristin Freed

Yale School of Nursing Digital Theses

Abstract Readmission Reduction of 1st Year Transplant Recipients Clear communication with patients at their health-literacy level improves patient outcomes, fosters trust, and is associated with readmission reduction. Readmission of transplant recipients are correlated with morbidity, medical errors, higher healthcare economic costs, and indicative of decreased survival post- transplant. Literature suggests that up to 72% of transplant recipients may have low health literacy increasing risk of readmission. The Agency of Healthcare Research and Quality created the REALM-SF assessment as a tool for medical providers to evaluate a patient’s health literacy status in a timely manner. This Doctor of Nursing Practice (DNP) …

New Leader Mentoring: Guiding Nursing Leaders Of The Future, Renee Marie Hammond

Yale School of Nursing Digital Theses

Nursing leaders throughout our health care system are retiring or leaving at an alarming rate – over 60% of the nursing leader workforce is expected to leave in the next five years. Retention of new nurse leaders is crucial to retention of clinical nurses, morale, and patient outcomes. Development of a formal mentorship program between new nurse leaders and experienced nurse leaders is essential to reducing the intent to leave of leaders. The Aims of this project are to develop a mentorship program for new nurse leaders using an adaptation of the American Organization for Nursing Leadership Core Competencies, to …

Empowering Emerging Air Medical Leaders Through A Novel Professional Development Program Adapting National Nursing And Healthcare Management Competencies To A Multi-State Air Medical Service, Christopher Hardman

Yale School of Nursing Digital Theses

Empowering Emerging Air Medical Leaders through a Novel Professional Development Program Adapting National Nursing and Healthcare Management Competencies to a Multi-State Air Medical ServiceHigh turnover in the nursing workforce has led to clinicians with limited experience being promoted to leadership roles without proper training or support. Nurse leaders directly impact clinical outcomes and retention. The financial burden of turnover is significant, as health systems must continually replace employees. Despite this, limited evidence exists on effective professional development and retention strategies in non-traditional, non-hospital settings. This DNP project sought to adapt and implement a novel professional development program, derived from the …

Nursing Innovation As A Solution To Improve Care Delivery, Danielle Therese Huseman-Maratea

Yale School of Nursing Digital Theses

Healthcare in the United States is complex and expensive. The 2023 per capita national health expenditure for the United States was $14,570 and 31% of national health expenditures were related to hospital care (Centers for Disease Control and Prevention, 2024). Healthcare innovation is a solution to this problem as it can improve quality and reduce cost (Walker, 2011). The value of nurses’ contribution around innovation tables was demonstrated during the COVID-19 pandemic (Koszalinski et. al, 2021). A 2020 study conducted by Johnson & Johnson, the American Nurses Association, and the American Organization for Nursing Leadership found that only 46 percent …

Improving Equity In Atherosclerotic Cardiovascular Disease Risk, Jordan Levandoski

Yale School of Nursing Digital Theses

The current use of racial categorization in Atherosclerotic Cardiovascular Disease (ASCVD) risk, limits assessment of confounders beyond cholesterol. The Life’s Essential Eight (LE8) categories of healthy diet, sleep, physical activity, smoking, body mass index, hypertension, total cholesterol, and blood glucose could reduce two million ASCVD events per year. The documentation of Z codes 55 – 65 describe social drivers of health (SDH) like housing, economics, and social systems which complicate care. Development of the ASCVD risk assessment and management protocol (ASCVD-RAMP) assessed ASCVD risk without race modification in patients aged 45 – 75 and improved health equity by pairing SDH …

Exergaming Physical Exercise Program Protocol For Older Adults With Mild Cognitive Impairment, Yushiu Lin

Yale School of Nursing Digital Theses

Physical inactivity is a risk factor for dementia and may accelerate the progression ofmild cognitive impairment (MCI). Older adults with MCI often engage in insufficient exercise, increasing their risk. This clinical intervention evaluated the effects of an exergaming physical exercise program on cognitive function and balance in older adults with MCI. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA), while balance was evaluated with the Romberg Test. The aims involved developing and implementing an eight-week exergaming physical exercise program, using a pre-packaged, non-immersive virtual reality (VR) application. Results indicated a significant improvement in cognitive function following increased physical …

Cultural Intelligence For Advanced Practice Providers: Moving A Contextually Based Model Forward For Workforce Training, René Padilla

Yale School of Nursing Digital Theses

Cultural Intelligence for Advanced Practice Providers: Moving a Contextually Based Model Forward for Workforce TrainingCultural Intelligence (CQ) among clinicians in primary care for the Hispanic population is inadequate (Da Costa, 2023). Cultural diversity training for patient care has been identified as a need to improve outcomes since the 1960s (Lin et al., 2017). In 2000, the Office of Minority Health (OMH) at the US Department of Health released the National Standards for Culturally and Linguistically Appropriate Services in Healthcare and updated those standards in 2013. Mainous et al. (2020) found that only 35% of primary care providers (PCPs) knew of …

Promoting Mental Health Awareness And Reducing Stigma In Spanish-Speaking Communities Through Educational Interventions, Kelly Medina Prado

Yale School of Nursing Digital Theses

Background: Spanish-speaking Latino populations in the U.S. experience significant disparities in mental health access driven by language barriers, low mental health literacy, and cultural stigma. These factors contribute to the underutilization of services, early treatment dropout, and poor outcomes.

Objective: This quality improvement project aimed to develop, implement, and evaluate a culturally and linguistically tailored mental health education intervention designed to increase mental health literacy and reduce stigma among Spanish-speaking Latino adults in a federally qualified health center.

Methods: A total of four group sessions were conducted over an eight-week period. The sessions were delivered in Spanish and included culturally …

Improving The Reporting And Tracking Of Hospital-Acquired Pressure Injuries, Melinda Rosado

Yale School of Nursing Digital Theses

Hospital-acquired pressure injuries (HAPIs) affect millions of patients a year, impacting patient safety and creating a significant financial burden for healthcare systems. Inadequate reporting and tracking of HAPIs lead to delays in care, inaccurate data reporting and missed opportunities for quality improvement. This is in large part due to a lack of training and education around HAPIs, poor communication of injuries during hand-off and a lack of system integration. A process improvement program to improve the reporting and tracking accuracy of HAPIs was piloted on two post-surgical units in a large urban cancer center. This initiative combined comprehensive training via …

Changing The Vantage Point Of Nurses Toward Evidence-Based Practice: Embedding Storytelling Into A Novel On-Demand Micro-Learning Program, Janet Ruscoe

Yale School of Nursing Digital Theses

CMS withholds billions in payments to fund VBP and incentivize hospitals to improve care. Achievements in TPS, which includes patient satisfaction and safety domains, is an opportunity to earn back incentive payments. Advancing nurses' adoption of EBP helps keep patients safe, improves satisfaction, and supports hospital financial viability (Kemp et al., 2023). However, gaps exist in the competency and application of EBP (Melnyk et al., 2018). A curriculum was developed to improve nurses' perceptions of EBP value. A storytelling, micro-learning approach was utilized to deliver the EBP-relevant knowledge. The digital platform provided on-demand, unlimited re-entry features that optimized flexibility, convenience, …

Provider Mindfulness: Changing Implicit Bias And Improving Perinatal Health Outcomes For Patients With Adverse Social Determinants Of Health, Nina Sarah Simon

Yale School of Nursing Digital Theses

AbstractProvider Mindfulness: Changing Implicit Bias and Improving Perinatal Health Outcomes for Patients with Adverse Social Determinants of Health Purpose: Implicit bias is an unconscious prejudice or preexisting belief developed over time toward another group. It can influence provider judgement, treatment decisions and levels of care. The purpose of this DNP Quality Improvement (QI) project was to improve patient care and provider knowledge on how implicit bias affects perinatal health for those with adverse social determinants of health (SDOH). Methods: A 53-second daily mindfulness intervention was developed and implemented among 8 obstetric providers caring for a population at risk for bias …

Developing A Standardized Workplace Violence Prevention Program For Healthcare Leaders To Enhance Safety, Kaleena Soorma

Yale School of Nursing Digital Theses

Abstract

Developing a Standardized Workplace Violence Prevention Program for Healthcare Leaders to Enhance Safety

The increasing threat of Type 2 workplace violence (client on staff) in healthcare disproportionately impacts employees such as Nurses. Desensitization to this growing trend in healthcare has contributed to perceptions that WPV has become an unavoidable risk, especially for those delivering care in high-risk areas such as the emergency department (ED).

The critical need to reevaluate WPV prevention strategies in healthcare, while highlighting systemic failures such as underreporting, is integral to driving a culture of safety. This project aimed to provide a post-incident Type 2 WPV …

Implementing A Patient-Centered Pediatric Obesity Protocol In A Population With Social And Environmental Risk Factors, Carolyn Walsh

Yale School of Nursing Digital Theses

Children and adolescents exposed to adverse childhood experiences (ACEs) and negative social determinants of health (SDoH) have an increased risk of developing pediatric obesity. The American Academy of Pediatrics Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (2023) recommends assessing these factors in children with obesity. At a School-Based Health Center (SBHC), the standard of care for pediatric obesity did not include ACEs and SDoH screening, highlighting a gap in practice. This Doctor of Nursing Practice project developed, implemented, and evaluated a patient-centered pediatric obesity protocol incorporating ACEs, SDoH screening, and referrals to patient-centered …

Jcu 211 Syllabus, Asako Tochika

Open Educational Resources

Syllabus for the Japanese Food Culture course. Taught as a COIL/study abroad course in the summer.

English 111 Syllabus, Jackie Weber

Open Educational Resources

This is the first part of a course sequence in English Composition that fulfills the Pathways Required Common Core: English Composition. Upon successful completion of ENG 111, you will proceed to ENG 121. In this course, we will work together to bring your writing to the level of college academic standards. Our work will focus on organization, grammar, and mechanics, as well as strategies for developing and presenting complex ideas. We will engage in academic topics and practice writing in different rhetorical modes.

Sci Peer Mentoring & Community Engagement: A Review, Caitlyn Menard

Student Research Design & Innovation Symposium

Each year, about 250,000 to 500,000 individuals sustain a spinal cord injury (SCI), resulting in decreased social participation and diminished societal engagement. This diminished quality of life hinders a person’s ability to fulfill societal roles (Beauchamp et al., 2016). Sustaining an SCI leads to a loss of performance skills and restricts the ability to participate in meaningful activities as one could prior to the injury (Beauchamp et al., 2016). The current standard of care indicates that individuals with an SCI engage in rehabilitation services and receive training from skilled clinicians and peers living with an SCI. Community-dwelling individuals with SCI …

Fungal Recycling, Arden Yale, Alannah Ridgway

Student Research Design & Innovation Symposium

Fungal recycling is a developing technique that turns garbage into food. To do this, the presenters created a new method of growing fungi of all different types (e.g. white oyster, lion's mane, etc.) and inoculating them into bags. These bags are sterile and contain a few key ingredients: coco coir, grain pellets, and shredded cardboard boxes. These boxes are taken from anywhere, mostly from lab equipment. Using the coco coir and grain pellets as a "starter", the fungi used the cardboard as a growing medium, literally growing food from trash. The technique is currently being refined. This project could bring …

Wearable Lanyard Acc For On-Demand Communication, Valerie Rosario, Rileigh Kearney, Hailey Soares, Kristen Martinez, Hannah Pereira

Student Research Design & Innovation Symposium

Augmentative and Alternative Communication (AAC) devices help individuals experiencing challenges with verbal communication, including English language learners, individuals who are hard of hearing, on the autism spectrum, or those experiencing anxiety disorders. Current technologies include low-tech communication boards and complex mobile applications, but both of these offer little customization. Our prototypes integrate touch-sensing panels and small LCD screens into common wearables, like necklaces and lanyards, so that the ACC discretely blends in with everyday apparel and provides on-demand communication that is customizable to the individual user. The touch-sensing pads are sensory-friendly, and the LCD screens operate without sound to support …

Cannabis & Insomnia, Audrey Brown, Casey Fanning, Finnian Crozier, Keyanna Metts

Student Research Design & Innovation Symposium

As cannabis becomes more accessible and popular, it is important to know how it affects cannabis users and their sleep patterns. It is important to ask how cannabis impacts insomnia, and if there are negatives or positives of using cannabis to help insomnia. Many people use cannabis as an agent to help with insomnia. It is important to research and understand if it helps people sleep better or if it results in more struggles with insomnia. The data was collected with a digital, cross-sectional, quantitative survey given to 1,022 participants who were between the ages of 18-25 years old and …

Alterations In Whole Muscle Quality And Physiological Cross-Sectional Area Measured With Quantitative Mri Following Acl Injury, Meredith K. Owen, Lauren Richardson, Darren L. Johnson, Moriel H. Vandsburger, Thorsten Feiweier, Katherine L. Thompson, Christopher S. Fry, Peter A. Hardy, Brian W. Noehren

Physical Therapy Faculty Publications

Background: Emerging evidence suggests that there are morphological and physiological changes to the vastus lateralis after an anterior cruciate ligament (ACL) tear. However, it is unclear whether these alterations are limited to just the vastus lateralis or are more representative of widespread changes across the thigh musculature and/or if these changes precede reconstruction. The purpose of this study was to determine T1ρ relaxation time, a measure of extracellular matrix organization in muscle, and physiological cross-sectional area (PCSA) for muscles of the quadriceps and hamstrings of the ACL-deficient and contralateral limbs soon after ACL injury.

Methods: T1ρ and diffusion …

Effects Of An Active Ankle Exoskeleton On The Walking Biomechanics Of Healthy Men, Sridevi Nagaraja, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Active lower-body exoskeleton devices can decrease the energy requirement of the human body by providing mechanical assistance to lower-body muscles. However, they also alter gait kinematics and kinetics, and it is not well understood whether such alterations are detrimental or beneficial to the human body. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on the biomechanics of men while carrying a heavy load. We collected computed tomography images and motion-capture data for five young, healthy men who walked 5 km (∼60 min) with a 22.7-kg load, with and without an active ankle exoskeleton …

Table Of Contents (V. 49, No. 2)

William & Mary Environmental Law and Policy Review

No abstract provided.

A Human Right To A Sustainable Climate?, Ottavio Quirico

William & Mary Environmental Law and Policy Review

Is a fundamental right to a sustainable climate progressively being recognized globally? Climate change is triggering parallel progressive developments in the human rights arena at both the domestic and international levels. Firstly, it is fostering an extensive interpretation of first- and second-generation human rights, protecting collective environmental interests rather than individual entitlements. Secondly, climate change has decisively accelerated the evolution of first and second generation human rights into a third generation right to a sustainable environment. Thirdly, emerging evidence discloses the possibility of conceiving a specific human right to a sustainable climate. This Article explores the trajectory of climate rights …

Recent Expansion Of Gubernatorial Emergency Powers To Address The Covid-19 Pandemic: Examining Applications For The Climate Crisis, Juliet Israel

William & Mary Environmental Law and Policy Review

With a particular focus on the states of California and Florida, this Note delves into the leadership roles assumed by governors when addressing the global COVID-19 pandemic, evaluates the applicability of this gubernatorial strategy to the climate crisis, and examines the criticisms and constitutional challenges to expanding gubernatorial emergency powers. Part I explores the core similarities and differences between the COVID-19 pandemic and climate change. Part II addresses the failure of federal and international policy responses to both the pandemic and climate change. Part III details the states’ use of gubernatorial emergency powers to respond to COVID-19. Part IV then …

Lessons Learned From The Mountain Valley Pipeline: Can Nature's Rights Or Environmental Justice Be The New Mvps In Pipeline Litigation?, Caitlin Kwalwasser

William & Mary Environmental Law and Policy Review

This Note will provide an introduction and proscriptive application of two litigation strategies for future pipeline litigation by using the MVP [Mountain Valley Pipeline] as a case study: (1) environmental justice and (2) nature’s rights. To understand how these strategies differ from the present, Part I will first examine the primary way opponents sought to prevent construction in the case of the MVP: challenging agency findings. Then, Part II will provide context for the two proposed litigation strategies. Finally, Part III will describe possibilities for how these strategies might be employed to prevent the construction of future pipelines.

This Note …

Made In The Usa: A Prison Of Our Own Emissions: Examining The Carbon Footprint Of Mass Incarceration From A Global Perspective, Raina Machisen

William & Mary Environmental Law and Policy Review

Part I will address the concept of Mass Incarceration and carbon footprints. Part II will describe and compare the current energy consumption level of the United States’ prisons and carbon emissions with the United Kingdom’s prisons’ green infrastructure. Part III suggests potential prison programs that encourage both rehabilitation and carbon reduction. Part IV discusses the origins of Mass Incarceration, potential policy solutions to reduce prison populations, and the prospect of repurposing unused prisons.

This abstract has been taken from the author's introduction.

Adventist Human Subject Researchers' Association Research Conference: June 25-28, 2025, Andrews University

Human Subject Research Archive

Program Book

Curaçao's Tourism Transformation: Building A Legacy Of Growth, Manuel Rivera, Margaret Zorrilla

Dick Pope Sr. Institute Publications

Tourism in Curaçao has experienced remarkable growth, with total arrivals increasing from 582,400 in 2023 to 700,242 in 2024. This surge reflects the island’s rising appeal as a destination and sets the foundation for the significant economic contributions that follow.

Where Music Shapes A Legacy, Manuel Rivera, Margaret Zorrilla Cortez

Dick Pope Sr. Institute Publications

The 2025 Curaçao North Sea Jazz Festival (CNSJF) reinforced its reputation as one of the Caribbean’s leading cultural events, delivering substantial economic benefits, an outstanding visitor experience, and deepening loyalty to both the festival and Curaçao. CNSJF 2025 stands as a powerful engine for Curaçao’s economy, a benchmark for festival experiences, and a driver of lasting loyalty and advocacy for both the event and the island. Its legacy is not only musical but also economic and cultural, shaping how visitors connect with Curaçao for years to come.