Medicine and Health Sciences Commons^™

Improving Knowledge To Improve Care: Strengthening Nurse Expertise In The Emergency Management Of Diabetic Ketoacidosis, Minda Murphy

Master's Projects and Capstones

Abstract

Setting: A high acuity emergency department within a large hospital system. Problem: Nurses in the emergency department reported inconsistent understanding and utilization of the existing Diabetic Ketoacidosis (DKA) protocol. Pre-intervention survey results showed that 84% of nurses identified the DKA order set as confusing, and only 15% reported feeling “very comfortable” with the protocol. These knowledge gaps contributed to delays in glucose monitoring, inconsistent insulin administration, uncertainty about order-set responsibilities, and variable adherence to evidence-based management. Context: DKA is a time-sensitive, high-risk emergency that requires precise, protocol-driven actions to prevent complications such as electrolyte imbalance, cerebral edema, prolonged hospitalization, …

Synthesis And Evaluation Of Amidoximes As Potential Pharmaceuticals Against Antimicrobial-Resistant Bacteria, Prudence Mange

Honors Theses

The rise of antimicrobial-resistant bacteria in the healthcare industry has led to devastating effects in recent years, ranging from increased risks associated with hospital treatment to longer illness duration, which may eventually lead to increased death rates (Naghavi, Mohsen et al, 2024). To combat this ongoing challenge, this project aims to synthesize amidoximes, which are organic derivatives of carboxylic acids with an oxime and an amino acid group. Amidoximes have been utilized in various clinical applications, including antituberculosis medication, hypotensives, antiarrhythmics, antibacterials, and antifungals (J. Chil et al., 2011). -- The focus of this project was to test their antibacterial …

Quality Improvement (Qi) Project Aimed At Reducing 30-Day Hospital Readmissions For Patients With Congestive Heart Failure (Chf) Through Checklist Implementation, Gary Gutierrez

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Congestive Heart Failure (CHF) remains a leading cause of preventable 30-day hospital readmissions,

especially in outpatient and transitional care settings. This quality improvement (QI) initiative was

launched within a private internal medicine practice in Essex County, New Jersey, to address this issue

by implementing a standardized CHF management checklist. The checklist focused on four key

components: (a) comprehensive medication reconciliation, (b) tailored patient education, (c) timely

follow-up appointments, and (d) improved interdisciplinary communication. By integrating evidence-

based practices into a structured workflow, the QI project aimed to improve care coordination,

empower patients to manage their condition, and reduce preventable …

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …

The Impact Of High-Fidelity Simulation On Graduate Nursing Students’ Knowledge And Confidence In Septic Shock Management, Shaden Mustafa

Seton Hall University Dissertations and Theses (ETDs)

The purpose of this quality improvement (QI) Doctorate of Nursing (DNP) project was to create and evaluate the impact of high-fidelity simulation-based training (SBT) on graduate nursing students’ knowledge and confidence in diagnosing and treating septic shock. Outcomes were measured with pre- and post-simulation tests featuring competency questions and Likert-scale confidence ratings.

Accordingly, the two research questions guiding this project were: (1) How effective is high-fidelity simulation training in improving students’ knowledge and competence in managing septic shock? (2) How effective is high-fidelity simulation training in enhancing students’ confidence when caring for patients with septic shock?

Septic shock was selected …

Factors Affecting School Readiness And Level Of Distraction Among Black Children During Virtual Learning In The United States, Imani Barnes

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic necessitated an shift to mandatory virtual learning (VL) for kindergarten through grade 12 students, disrupting educational systems globally and exposing systemic inequities. Although researchers had explored health and education disparities separately, they had not adequately examined the intersection of child health, specifically body mass index (BMI) and health-affected ability, with school readiness and level of distraction in VL environments. The purpose of this quantitative, cross-sectional study was to examine associations between BMI, health affected ability, school readiness, and distraction levels among U.S. Black children engaged in VL in the 2020 school year, controlling for gender, age, and …

The Moral Crisis Of Maternal Mortality In The Us, Jensen F. Ware

Honors Theses

This thesis argues that the US crisis of maternal mortality is not an unavoidable tragedy, but a moral and policy failure. I argue that maternal well‑being is one of the most important indicators of a society’s overall health. When mothers receive the care, respect, and support they need, it reflects the strength of healthcare systems, the culture, and our commitment to future generations. The continued loss of mothers from preventable deaths reveals a system that fails many women and their families, especially Black women, low‑income women, and those in rural communities. First, I introduce the issue of maternal mortality in …

Role Of Cellular Stress Responses In Innate Immune Defense Against Acute Respiratory Infections, Amit Sharma

LSU Doctoral Dissertations

The endoplasmic reticulum (ER) stress sensor inositol-requiring enzyme 1α (IRE1α) is an important regulator of innate immune cells. However, its role in pulmonary innate host defenses remains poorly understood. This dissertation elucidates the dual, context-dependent role of IRE1α in host defense against methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. We demonstrate IRE1α’s function as both a detrimental mediator of acute pathology and an essential facilitator of innate immune memory. Our work revealed that acute IRE1α activation during primary MRSA infection is detrimental. In lungs and alveolar macrophages (AMs), IRE1α is activated in response to MRSA infection. Consequently, IRE1α activation triggers a hyperinflammatory …

Evaluating Fall Prevention Outcomes: Fall Rates, Staff Fall Knowledge, And Perceptions On Safety Culture, Priscilla Greco

Student Scholarly Projects

Practice Problem: The practice problem addressed in this project was the elevated fall rates on a 46-bed medical–surgical unit with a reported sentinel fall event, prompting the need to evaluate the current fall prevention program.

PICOT: The PICOT question that guided this project was: In nursing staff on a medical–surgical unit (P), how does the implementation of an evidence-based fall prevention program evaluation using AHRQ tools (I), compared with no formal program evaluation (C), influence staff knowledge, perceptions of safety culture, and fall rates (O) over 8-weeks (T)?

Evidence: Evidence supporting this project emphasized that structured staff education, strong communication, …

Social Media Use And Its Association With Eating-Related Attitudes And Behaviors In Rural University Students, Erin S. Clark

Honors College Theses

Context: Eating disorders (EDs) are psychiatric illnesses wherein atypical patterns of eating induce harmful physical and psychosocial consequences. ED rates have increased globally in recent years, jumping from an estimated 3.5% to 7.8% between 2006 and 2018. ED onset typically occurs in adolescence and early adulthood and results from complex interactions between biological, psychological, and social factors. One such social factor is social media (SM) usage.

Research Design: The present quantitative study examines how measures of SM use (including use intensity, activity, personal perceptions of SM, and initial age of introduction to SM) relate to ED risk among rural university …

Healthcare Access, Economic Stability, And Food Security And Inflammatory Bowel Disease In Hispanic Adults Living In The United States, Jennifer Rodriguez

Walden Dissertations and Doctoral Studies

Hispanic adults in the United States experience disparities in chronic disease detection and outcomes, including inflammatory bowel disease (IBD). Social determinants of health (SDoH), including economic stability, healthcare access, and food security, play a crucial role in shaping health risks and diagnostic opportunities in this population. The purpose of this quantitative cross-sectional study was to examine the relationship between selected SDoH factors and self-reported IBD diagnosis among U.S. Hispanic adults. This study utilized survey data from the 2023 National Health Interview Survey (n = 29,457). Weighted descriptive statistics and logistic regression were used to analyze the relationships between variables while …

Staff Education To Peri Operative Registered Nurses, Shahida P. Meghani

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to enhance perioperative nursing adherence to evidence-based practices for preventing surgical site infections (SSIs). SSIs remain among the most prevalent healthcare-associated infections, affecting 2%–5% of surgical patients and contributing to extended hospital stays, higher costs, and preventable morbidity. The practice-focused question guiding this project was: In adult surgical patients, how does the implementation of a perioperative nursing education program on SSI prevention, compared to standard practice, affect SSI incidence rates over a 2- to 4-month period? The project applied the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to …

High School Science Experience For Students With Cognitive Disabilities: A Pilot Study, Cassandra Wychers

Honors Theses

Although education has become more adaptive, inclusive of all students who learn differently including for people with cognitive disabilities, closer examination may reveal that high school science classrooms are still challenging learning spaces. Science is an important part of the school curriculum as it teaches students about engaging in the world around them while also encouraging skills involving evidence, inquiries, and critical thinking. All students are entitled to learn science in their classrooms even if they have a cognitive disability (Apanasionok, et al. 2019). Although there are many complexities to defining disability in the world and in education, this study …

The Effectiveness Of Telemedicine As A Pivotal Tool In Providing Accessible Medical Care, Peyton Wilt

Honors Theses

Telemedicine has emerged as one of the most transformative innovations in modern healthcare, offering new opportunities to bridge long-standing gaps in access, quality, and continuity of care. Rural and underserved communities in the United States face persistent barriers to healthcare, including provider shortages, geographic isolation, limited access to specialty services, transportation challenges, and socioeconomic disparities. These structural barriers often delay diagnosis, disrupt chronic disease management, and worsen overall health outcomes. Telemedicine provides a mechanism to address many of these obstacles by enabling remote consultations, real-time monitoring, follow-up appointments, and access to specialty providers through digital platforms.

This thesis examines the …

Expanding Epilepsy Representation: On Education And Awareness, Aliyah Wise

Honors Projects

The present-day American public education system has evolved to try to teach young students about more cultures and people of different lifestyles. However, despite these reforms to push for an inclusive education system, there is still minimal effort to teach students about disabilities and the people who live with them. As a student living with epilepsy, I have observed a lack of education or conversation about this disability. The purpose of this research project is to ask: How does miseducation on epilepsy contribute to harmful stereotypes and lead to real issues for people living with this disability? How should neurotypical …

Developing Nurse Knowledge And Confidence In Telehealth Delivery For Ptsd Care, Bisilola M. Yinusa

Walden Dissertations and Doctoral Studies

With posttraumatic stress disorder (PTSD) prevalence increasing and telehealth becoming more integrated into mainstream healthcare practice, it is critical to ensure that nurses are adequately trained to deliver evidence-based, trauma-informed care through digital modalities. The identified practice problem centered on the limited telehealth competency among nurses, particularly in communication strategies, confidence, and clinical readiness for PTSD care via virtual platforms. This doctoral project was a staff education initiative designed to enhance the telehealth delivery of trauma-informed care for patients with PTSD. The purpose of this project was to evaluate whether the structured educational intervention improved nurses’ knowledge and confidence in …

Prosodic Comparisons Between Speech And Music For Different Emotions, Reagan Brothers

Honors Projects

This study compares the prosodic acoustic characteristics between different emotional expressions in speech and clarinet playing and evaluates the similarities in prosody between these two domains. The prosodic features analyzed include pitch, loudness, and duration, which are the psychoacoustic terms referring to fundamental frequency [f_o], intensity, and rate of time. The American folksong “I’ve Been Working on the Railroad” was both spoken and performed with three emotions: neutral, sad, and happy. The first comparison was how each prosodic characteristic compared across the three different emotions within each domain, and then prosody was compared across the two domains …

The Timing Of Pubertal Onset Affects Adults Anxiety Behavior In A Sex-Specific Manner, Evan Raubenolt

Honors Projects

This study aims to look at the relationship between the timing of pubertal onset and its long-term effects on adult anxiety behavior in rats. Though the topic of pubertal onset has been frequently discussed in developmental research, its exact effects have been inconsistent. Human models have shown that early and late maturing males are associated with a notable increase in adult anxiety behavior, while in rat models, similar sex-specific effects regarding anxiety have been demonstrated, though those studies focus on a causal relationship between exposure to stress and age of pubertal onset. This study first aims to examine that relationship …

Art Therapists' Experience Utilizing Virtual Reality’S Multibrush In Group Art Making With Young Adults., Lidice Cohen

Expressive Therapies Dissertations

Young adults aged 20-35 experience disproportionately high rates of mental health conditions yet exhibit low treatment-seeking behaviors, creating a significant care gap. Digital interventions—particularly Virtual Reality (VR)—show promise for reaching this tech-savvy group. The primary research question explored art therapists' insights utilizing this modality, while a secondary aim examined whether creating VR response art (VRRA) enhanced understanding of the group process. Three credentialed art therapists and nine young adults participated, sharing insights via interviews after VR group sessions and VRRA creation. Thematic analysis revealed that adaptation to VR influenced group dynamics, self-expression through embodiment, collaboration, boundary management, sensory stimulation, and …

Spike Timing Depended Plasticity Produces Unsupervised Learning Of Synergistic Muscle Feedback In A Synthetical Neural Network, Mark Allen Pupkiewicz

Dissertations and Theses

This study investigates how type Ia feedback from muscle spindles can be organized into groups representing agonistic muscle pairs through Spike Timing Dependent Plasticity (STDP). A single degree of freedom joint is actuated with four biologically modeled muscles forming two agonistic pairs. In order to emulate the sensory dynamics of biological muscle spindles, sensors in the model record the active length and velocity states of each muscle, the two primary factors eliciting type Ia afferent responses. In biological networks, synapses from Ia sensory neurons frequently activate interneurons representing agonistic muscle sources. This research investigates whether this organization can emerge in …

Staff Education On Burnout For Mental Healthcare Staff Mitigation Strategies For Psychiatric Outpatient Staff, Kadine Foreman-Westly

Walden Dissertations and Doctoral Studies

The purpose of this project is to determine whether implementing a staff education program in a psychiatric clinical setting can improve healthcare staff knowledge of strategies to prevent burnout. The project addresses a critical practice problem: a lack of structured education programs specifically targeting burnout recognition and management among mental healthcare staff. Burnout not only negatively impacts staff well-being but also affects patient safety and the overall quality of care. This project was designed to fill this gap by providing an educational intervention, with effectiveness measured through pre- and post-intervention surveys assessing staff knowledge. This staff education project was strengthened …

Standardizing Syphilis Screening In Tennessee Correctional Facilities: A Policy Analysis, Erin Dernlan

DNP Projects

Background and Rationale

Congenital syphilis in Tennessee rose 227% from 2017-2021, despite being more than 90% preventable with timely diagnosis and treatment. Women of childbearing age entering correctional facilities represent a key intervention population due to disproportionally high rates of sexually transmitted infections, limited or absent prenatal care, and significant unmet health needs. Tennessee’s female incarceration rate is 57% higher than the national average, and nearly one-third of women tested at intake are positive for syphilis. Current intake practices rely heavily on self-report, assumed adequate health literacy, and lack standardized STI screening requirements, contributing to missed diagnoses and preventable infant …

The Importance Of A Pressure Injury Prevention Program In Acute Hospital Settings, Sarah Orial

Student Scholarly Projects

Practice Problem: The identified practice problem for this project was the lack of a standardized pressure injury prevention program in a 350-bed acute care hospital. The lack of a standard program could be leading to increased hospital-acquired pressure injuries. PICOT: In adult inpatients in a medical/surgical unit (P), does the implementation of a standard unit-based pressure injury prevention program (I) compared to the current practice (C) increase the percentage of nursing skin risk assessment documentation (O) over a 10-week period (T)?

Evidence: The literature supports the development of standard pressure injury prevention programs and continuing education to …

The Reception Of Neurodiversity Represented Within Netflix’S Wednesday, Anna Stevens

Graduate Theses & Dissertations

This paper explores how neurodiversity is represented through popular media - particularly Netflix's show Wednesday - and aims to discuss the effects this representation could have in regards to how it's received by the public, as well as those who are neurodiverse.

Operationalizing Flourishing In Bsn Nursing Education: A Cipp- Driven Strategy, Kennedy E. Hochstedler, Elizabeth Morse

DNP Projects

Operationalizing Flourishing in BSN Nursing Education: A CIPP- Driven Strategy

Holistic Approaches To Lyme Disease Symptom Management, Leah Van Antwerp

Honors Theses

Lyme disease is a multisystem tick-borne infection that can lead to long-lasting symptoms even after standard antibiotic therapy, with Lyme arthritis being one of the most common and persistent complications. Due to limited research on this issue, rheumatoid arthritis (RA) will be discussed as a reference for understanding treatment options because it is a similar condition. Since many people continue to experience debilitating pain and reduced quality of life after treatment for Lyme disease, holistic approaches have become increasingly popular for symptom management. This literature review examines three holistic modalities-yoga, acupuncture, and diet modifications- and their effectiveness in alleviating arthritic …

Pregnancy Intention And Maternal Morbidity In Oklahoma And Mississippi: A Moderation Analysis Of Abortion Restriction Policies, Vicki Johnson

Walden Dissertations and Doctoral Studies

More than half of all pregnancies are unintended (mistimed or unwanted), and women with unplanned pregnancies may face economic hardships for families and additional health consequences if they have pre-existing medical conditions. This quantitative study was conducted to examine the relationship between pregnancy intention levels and severe acute maternal morbidity, specifically chorioamnionitis, among women who gave birth in Oklahoma and Mississippi in 2022. Using secondary data (N=1939) from the Pregnancy Risk Assessment Monitoring System Automated Research Files and state-level abortion policy data from the Guttmacher Institute, this study employed Bronfenbrenner’s social ecological model framework to investigate the relationship between pregnancy …

Staff Education For Enhancing Providers’ Knowledge Of Long Acting Injectables (Lais) Antipsychotics In The Outpatient Mental Health Clinic, Belinda Okoruwa

Walden Dissertations and Doctoral Studies

This doctoral study is a quality-improvement educational program in an outpatient mental health clinic designed to address the underutilization of long-acting injectable (LAI) antipsychotics due to gaps in providers’ knowledge. The project question centered on whether structured education on LAIs antipsychotics increases providers’ knowledge in an outpatient mental health setting. The purpose of this project is to increase LAI antipsychotic utilization by educating providers about the advantages, safety, and appropriate administration to promote consistent implementation. In this project, I used a single-group pre/post design including six participants, incorporating a 12-item questionnaire and 5-point Likert scale questions (Not at all/Somewhat/Very Much). …

G6pd Deficiency, Annette C. Osias Arredondo

Honors Capstones

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive enzyme disorder affecting over 400 million people worldwide.G6PD is essential for producing NADPH, which maintains reduced glutathione (GSH)—the RBC’s primary defense against oxidative damage. When G6PD activity is low, RBCs cannot neutralize oxidants, leading to hemoglobin oxidation, Heinz body formation, and subsequent bite cells and hemolysis. Symptoms range from asymptomatic to acute hemolytic crises, especially after exposure to oxidative triggers such as infections, certain drugs, or fava beans.

A Quality Improvement Project: Faculty Education On Diversity, Equity, And Inclusion Principles, Ashley Mcdoulett

Doctor of Nursing Practice Projects

According to the literature, social injustices, inequities, and implicit bias influence health outcomes in marginalized populations. To eliminate health disparities, nurses should be prepared to provide care that addresses these issues, and faculty should be able to effectively integrate diversity, equity, and inclusion (DEI) principles into the nursing curriculum. A literature review suggests the integration of DEI into nursing education is lacking, and by offering an educational session for faculty on best practices for curriculum incorporation, this project aimed to address that gap. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) model guided this project. RE-AIM emphasizes targeting a population to …