Medicine and Health Sciences Commons^™

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash

Doctoral Dissertations and Projects

A shortage of both clinical nurses and nursing educators exists. These shortages have a multitude of impacts on the field of nursing, both at the bedside and in academia. The shortage of clinical nurses impacts the number of nurses available to provide quality patient care. The shortage of nursing educators can impact the number of students accepted into nursing programs and, in turn, the number of new nurses available to provide direct care to patients. The purpose of this quantitative non-experimental predictive correlational design study was to examine how the resiliency of nursing educators impacts their intent to stay in …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Implementation Of Asynchronous Mentor Education Modules To Improve Mentoring Competency, Elvira Sayfutdinova

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Structured mentorship supports new CRNAs as they transition to practice, fostering confidence, job satisfaction, and professional growth. The WashU Medicine Department of Anesthesiology (WUDA) launched a CRNA Mentorship Program in 2022, but it lacked standardized mentor education, leading to inconsistent mentor preparation and variable mentoring practices.

Review of Literature Findings: Structured mentor education improves mentoring competency across healthcare settings, yet the literature specific to CRNAs remains limited. Asynchronous, self-paced formats reduce barriers to participation for busy clinicians, but no prior study has evaluated a fully asynchronous, prerecorded mentor-education format for CRNAs.

Methods: This pre-/post quality improvement (QI) …

Palliative Care Consults In The Intensive Care Unit, Kyra Zimmer

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Intensive care unit (ICU) patients often face serious illness or terminal diagnoses requiring invasive monitoring and life-sustaining treatments. Palliative care (PC) supports patients and their families by focusing on improving quality of life, goals of care, and symptom management. It is estimated that 14-20% of ICU patients in the United States could benefit from palliative care consults (PCCs) with potential savings of $6 billion per year. Nurses caring for these patients face unique ethical challenges and may develop secondary post-traumatic stress, emotional strain, burnout, and compassion fatigue.

Review of Literature: The review of literature supported a structured …

Implementation Of A Learning Module To Reduce Advanced Practice Provider Preceptor Burden, Michelle Bloom

Doctor of Nursing Practice (DNP) Student Projects

The transition of advanced practice providers (APPs) from student to provider, or from an experienced provider to a new organization or location, has been identified as a high-stress period with potential turnover for new-hire APPs. APP preceptors play a key role in this transition. Limited time to teach during the clinical day and a limited knowledge base among new hires were two of many factors associated with increased preceptor burden. A brief online educational module that provided pre-clinical, organization-specific education was proposed to improve new-hire APPs’ knowledge base and reduce preceptor burden, among APP preceptors working in a 36-bed surgical/burn/trauma …

Reimagining Clinical Education: Interprofessional Simulation And Clinical Skill Readiness In Nursing And Occupational Therapy Curricula, Gretchen Johnson, Linda Barnett, Lori Aaron-Brija, Emily Berkowitz

Internet Journal of Allied Health Sciences and Practice

Purpose: As the healthcare landscape evolves, education for health professionals must prepare future practitioners to meet emerging challenges and navigate diverse care settings. Integrating interprofessional education (IPE) opportunities within healthcare curricula supports the development of essential clinical skill competencies and collaboration across multiple disciplines. The Clinical Skill Readiness interprofessional model prepares students for successful clinical rotations by integrating assessment and skill development. Students develop vital interprofessional skills, with specific emphasis on communication, professionalism, and role clarity, all of which are essential for effective practice in a collaborative clinical setting. Methods: Nursing and occupational therapy students participated in timed treatment sessions …

Strategies To Improve Outcomes Of Obstetric Emergencies In Sub-Saharan Africa: A Scoping Review, Serah Wachira, Ruth Wagathu, Beth Waweru, Rose Maina, Abednego Ongeso, Constance Sibongile Shumba, Benard Mutwiri, Diana Mbattude, Cliff Aliga, Lucy Kisaka, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background: Obstetric emergencies remain a leading cause of maternal morbidity and mortality in sub-Saharan Africa (SSA) despite increased access to facility-based deliveries and emergency obstetric care. Improving outcomes requires not only life-saving clinical interventions but also effective health system strategies. This review mapped published evidence on strategies used to improve outcomes of obstetric emergencies in SSA.

Objective: This scoping review aimed to identify strategies reported in the literature to improve outcomes of obstetric emergencies in SSA.

Methods: The review was reported in accordance with PRISMA-ScR. A comprehensive electronic search of PubMed, CINAHL, SCOPUS, and CORE identified studies published between January …

Towards Primary Health Care Education Reform: A Reflexive Thematic Analysis Of Nursing Supervisors' Perceptions, Experiences And Challenges, Debbie Procter, Mccullough, Debbie Massey, Karen Strickland

Research outputs 2022 to 2026

Aim: To explore Primary Health Care nurses' experiences of supervising nursing students on clinical placements and their perceptions of academic preparation for placement and future employment. Background: Primary Health Care nurses are essential workers within sustainable health systems but pre-registration educational preparation and access to clinical experiences can be limited. Previous research correlates positive clinical experiences with workforce intentions. Furthermore, nursing supervisors are pivotal to maximising student experiences and education, yet little is known about their perceptions, challenges, and views about how current curriculum prepares students to commence professional careers in primary care. Understanding their perceptions may inform curriculum, improve …

Nurses' Perspectives Of Dysphagia Screening Practices In Irish Residential Long-Term Care Settings: A Qualitative Descriptive Study, Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney

Research outputs 2022 to 2026

Objectives To examine nurses’ perspectives on current dysphagia screening practices in Irish residential long-term care settings (RLTCS), and to investigate barriers and facilitators to nursing-led dysphagia screening within this healthcare context. Methods This study employed a qualitative descriptive design and was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Participants were recruited through purposive sampling from RLTCS located in the northeast of the Republic of Ireland. Eleven in-person focus group interviews were conducted with thirty-four nurses working in clinical and managerial roles. A semi-structured interview guide was utilised, and the data were subsequently analysed using reflexive …

Neonatal Assessment And Vr: Designing 3d Simulation Training For Prehospital Clinicians, Michella G. Hill, Luke Hopper, Belinda Flanagan, Sara Hansen, Alecka Miles, Jess Watson, Sean Cashman, Kirstie Balding, Peggy Dysktra, Joshua Johnson, Brennen Mills

Research outputs 2022 to 2026

Prehospital emergency care requires clinicians to manage a vast array of medical and trauma incidents, including rare events such as obstetrics (i.e., childbirth) emergencies. Emergency births can have life-threatening complications such as neonatal respiratory distress potentially leading to cardiopulmonary resuscitation. Management of low-frequency high-risk (LFHR) events such as birthing and immediate neonatal care occurring outside the planned place of birth require expert clinical management. Underutilised skill and knowledge of LFHR events decay within 12-months of being taught. LFHR events are often overlooked for refresher training due to the low occurrence of such cases, putting LFHR patients at even greater risk …

Pediatric Nurses' Perspectives Of Integrating Spiritual Care Into Everyday Practice: An Integrative Review, Yin May Htay, Mandie Foster, R. Mowat

Research outputs 2022 to 2026

Aim: To explore nurses' perspectives regarding children's spiritual care in pediatric healthcare settings. Background: Spiritual care is a fundamental source of comfort and healing and an essential. component of nursing practice. However, pediatric nurses often lack the competence and confidence to incorporate spiritual care into their clinical routines. Despite its importance, the perceptions and practices of pediatric nurses across various clinical specialties regarding spiritual care remain underexplored in current literature. Methods: The integrative review methodology was chosen to provide a comprehensive and up-to-date synthesis of the literature. Four electronic databases (CINAHL, MEDLINE, Scopus and Google Scholar) were used to search …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …

Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi

Walden Dissertations and Doctoral Studies

The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …

Staff Education To Increase Knowledge And Awareness Of Sexually Transmitted Diseases, Alie Sholola Sahid

Walden Dissertations and Doctoral Studies

Background STIs or sexually transmitted diseases (STDs) are consequential public health emergencies that affect millions of people globally and have long-term health implications (Garcia et al., 2024). STIs are infections that are passed from one person to another through sexual contact with the most common types of STIs include chlamydia, trichomoniasis, general herpes, and human papillomavirus (HPV). It is estimated that each year, more than 20% of the U.S. population has had an STI, with around 26.2 million cases per year (Centers for Disease Control and Prevention [CDC], 2024a). The common types of STIs include chlamydia, trichomoniasis, general herpes, and …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

Tracking Towards Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Carolina Maria Gerodias Cayetano

Master's Projects and Capstones

Background: Central line-associated bloodstream infections (CLABSIs) remain among the most serious and costly healthcare-associated infections in acute care settings, with each event associated with significant excess mortality, prolonged hospital stays, and avoidable healthcare costs. At Hospital A, a 239-bed acute care facility, two of six total CLABSI events over a 12-month period were associated with peripherally inserted central catheters (PICCs), representing 33% of all facility CLABSIs and exposing a critical gap in standardized PICC line surveillance and maintenance bundle monitoring.

Problem: The PICC team lacked a systematic, real-time tracking mechanism to monitor central line maintenance bundle adherence across seven adult …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh

Walden Dissertations and Doctoral Studies

Patient falls remain a major patient safety concern, particularly among hospitalized stroke patients who are at increased risk because of impaired mobility, neurological deficits, and cognitive changes. The inpatient stroke unit selected for this quality improvement project consistently reported the highest fall rates within the hospital system, highlighting the need for evidence-based interventions. The purpose of this project was to determine whether a structured fall-prevention education program incorporating evidence-based practices and the 4Ps of purposeful rounding (pain, potty, position, and possessions) would improve staff knowledge, increase compliance with fallprevention practices, and reduce patient falls over a 2-month period. Guided by …

Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education project regarding Candida auris, a multidrug-resistant fungus recognized by the Centers for Disease Control and Prevention (CDC) as an urgent global health threat due to its high mortality, environmental persistence, and resistance to common disinfectants. Staff play a crucial role in infection prevention; however, limited awareness and inconsistent knowledge of Candida auris contribute to potential transmission in skilled nursing home settings. The project question was as follows: Among staff members in a skilled nursing facility, does an evidence-based educational intervention improve knowledge of Candida auris infection prevention as compared pre- …

The Experience Of Wellness And Self-Care For Graduating Bsn Students, Jenny Pappas, Terri A. Clark, Tasha Ruffin, Deborah Ellison, Adrienne Wilk, Debra Rose Wilson

Journal of Social, Behavioral, and Health Sciences

The aim of this study was to explore how graduating prelicensure bachelor of science in nursing (BSN) students experience self-care and wellness, with the goal of informing future curriculum development. Nursing students face significant academic, emotional, and sociocultural pressures that heighten vulnerability to burnout. Despite widespread agreement that self-care is a professional expectation, little is known about the students’ experience within demanding programs. Guided by Orem et al.’s (2001) self-care deficit theory, a qualitative study using interpretive hermeneutic phenomenology was used to examine lived experiences of self-care and wellness. Sixteen graduating BSN students participated in in-depth, semistructured interviews. Interviews were …

Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson

Walden Dissertations and Doctoral Studies

Nurses play a central role in shaping patient experiences through clinical care and relational service behaviors. However, little is known about registered nurses’ perceptions and experiences of relational service behaviors in contemporary health care settings. The purpose of this interpretive description qualitative study was to explore registered nurses’ perceptions and experiences of relational service behaviors and their role in promoting patient-centered care. Herzberg’s two-factor theory provided the conceptual framework for examining how intrinsic motivators and extrinsic workplace factors influence relational engagement. Semistructured interviews were conducted with 11 registered nurses from diverse clinical practice settings. Interview data were analyzed using Braun …

Staff Education To Improve Healthcare Staff Knowledge Of An Electronic Scheduling System In An Intensive Outpatient Program (Iop), Catherine Kinyili

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project aimed to improve staff knowledge of the newly implemented electronic scheduling and booking kiosk system. A transition from a paper-based to an electronic scheduling system led to reduced staff efficiency, communication challenges, scheduling errors, and delays in patient care. An evaluation identified inconsistent staff knowledge of the newly implemented electronic scheduling system. The practice-focused question for the project was: Among healthcare staff in an intensive outpatient program, how does a one-time structured education and training session affect staff knowledge of a new electronic scheduling system? The purpose of this project was to …

The Evaluation Of The Epic Epidural Assessment Event And The Effects Of The Conversion Of Epidural To General Anesthesia For Cesarean Sections, Rebecca Turney, Bridget Shinnick

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Unplanned conversion from labor epidural analgesia to general anesthesia (GA) for cesarean delivery is associated with increased maternal and neonatal risk and may occur when inadequate epidural function is not recognized before operative delivery. This Doctor of Nursing Anesthesia Practice quality improvement project evaluated implementation of the Epic Epidural Assessment Event, a structured electronic medical record documentation tool designed to standardize epidural assessment during labor at a high-acuity obstetric referral center in Western Pennsylvania. Using a Plan-Do-Study-Act framework, the project compared pre- and post-implementation epidural-to-GA conversion trends, reviewed Epic audit data for documented tool utilization, and collected anonymous anesthesia provider …

A Quality Improvement Project On Maternal Hemorrhage Protocol Adherence, Cyrus Masih, Richard Zapata

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage is a leading cause of preventable maternal morbidity and mortality and requires rapid, coordinated response among obstetric, anesthesia, nursing, and blood-bank teams. This quality improvement project implemented and evaluated a California Maternal Quality Care Collaborative (CMQCC)-based Code OB maternal hemorrhage intervention at a western Pennsylvania hospital. The project aimed to improve anesthesia provider knowledge, confidence, and readiness to recognize, stage, and respond to maternal hemorrhage using standardized guidance, quantitative blood loss (QBL) measurement, and point-of-care cognitive support. Guided by the Institute for Healthcare Improvement Model for Improvement and a Plan-Do-Study-Act cycle, the intervention included a focused educational presentation …

Implementation Of A Discharge Planning Protocol, Sylvia Ngwikooh Forku

Walden Dissertations and Doctoral Studies

This doctoral project was a nursing led quality improvement initiative focused on standardizing discharge planning on an adult inpatient psychiatric unit. The goal of the project was to strengthen evidence-based, person-centered transitions of care to reduce readmissions and promote safer community reintegration for adults with serious mental illness. The practice focused question guiding this project was whether implementing an evidence based, standardized discharge planning protocol on an adult inpatient psychiatric unit would improve staff knowledge and adherence to best practice discharge elements and contribute to a favorable decrease in 30-day readmission rates. Analytical strategies included descriptive analysis of pre and …