Medicine and Health Sciences Commons^™

Primary Care Provider Communication Barriers With College-Aged Students, Mckenna Mahakian, Sharon Schaeffer, Rachel Immel

Honors Projects

As both a researcher and a college student, I’ve noticed that my peers and I share a common negative sentiment toward scheduling and attending routine doctor’s appointments. There are unique barriers in place for the age demographic; college students encountering the medical system and Primary Care Providers (PCPs) seem to have unique challenges in communication. I released a qualitative, anonymous survey to Bowling Green State University students to gauge opinionated responses on sentiments regarding how they felt about the level of communication between themselves and their provider, how the pediatric switch to a regular doctor impacted their inpatient care, how …

Clinical Practice Guideline On Reducing Catheter -Associated Urinary Tract Infections (Cautis), Nkechi Christiana Udah

Walden Dissertations and Doctoral Studies

The project was a clinical practice guideline (CPG) for early catheter removal to prevent catheter-associated urinary tract infections (CAUTIs). At the project site, the practice gap was the surgical nurses’ nonadherence to clinical guidelines for reducing CAUTIs. This gap resulted in inconsistent catheter care practices and delays in catheter removal. The purpose of this CPG was to enhance surgical nurses’ knowledge and adherence to clinical guidelines for reducing CAUTI rates. The following practice-focused question guided the project: In hospitalized patients in acute care settings, does early removal of the urinary catheter compared to leaving the catheter until discharge reduce the …

Enhancing Sepsis Prevention In Long-Term Care Facilities: Development Of An Infection Prevention Sepsis Toolkit, Emmalyn A. Tuhin

Student Scholarly Projects

Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to create, validate, and refine an Evidence-Based Sepsis Prevention Toolkit to enhanced early sepsis recognition and interprofessional coordination of care within long-term care facilities (LTCFs).

Background: Sepsis remains a leading cause of mortality and preventable transfer to the hospital for the elderly residents within the LTCFs. A significant practice gap persists because sepsis in this population often presents atypically, resulting in delayed or inaccurate diagnosis and treatment.

Methods: This project was guided by the following PICOT question: For healthcare professionals caring for patients aged 65 years and older …

Unsaturated Fatty Acid Oil-Based Microdroplets: A Promising Novel Class Of Microdroplets, Ramiz S. Alejilat

Seton Hall University Dissertations and Theses (ETDs)

Droplet-based microfluidics has rapidly advanced numerous fields, including chemistry, biology, materials science, medicine, food science, and cosmetics. In these systems, fluorocarbon oil combined with fluorinated surfactants is the preferred medium for fluid encapsulation, offering exceptional stability and biocompatibility essential for sensitive biological and chemical processes. However, growing concerns about the environmental and biological risks associated with fluorinated chemicals have prompted a search for alternatives.

This study is the first to explore the use of unsaturated fatty acids derived from emu oil for microdroplet formation. We characterized droplet formation based on flow rates and the presence non-fluorinated surfactant at a certain …

Medicaid Funding And Health-Related Social Needs: A Policy Analysis, Passion Ilea

Dissertations and Theses

The U.S. has disproportionately high health care spending compared to other high-income nations and comparatively poor health outcomes. The Centers for Medicare and Medicaid Services (CMS) have recently increased emphasis on addressing Medicaid member social needs. CMS believes addressing health-related social needs (HRSN) may reduce costs and improve health outcomes for Medicaid members. CMS has begun to test theories regarding the impact of member HRSN on health care by designing federal mechanisms to address HRSN, such as in lieu of services and settings-funded services, and by encouraging state Medicaid programs to develop their own approaches, such as Flexible Services. Information …

Mental Wellness: Breaking Down Barriers To Mental Health Treatment For Veterans, Merita Dallta

Capstones

No abstract provided.

Social And Contextual Factors Influencing Hypertension Among Latino Men Living In California, Leslie Ivett Ortega

Walden Dissertations and Doctoral Studies

Hypertension remains a critical and often silent public health issue that disproportionately affects Latino men in California. This quantitative, retrospective cross-sectional study explored the social and contextual factors influencing hypertension among this vulnerable population. Using the 2019 Behavioral Risk Factor Surveillance System dataset, which included a sample size of 2,060 participants, the study examined the relationship between hypertension and key variables including primary care utilization, health insurance, smoking, physical activity, mental health, and marital status, while controlling for age, education, and income. Guided by the health belief model, binary logistic regression analyses found health insurance and primary care utilization significantly …

Facilitating Timely Initiation Of Hiv Care Through An Interdisciplinary, Algorithm-Guided Approach, Courtney Harris

DNP Projects

ABSTRACT

BACKGROUND: Initiation of antiretroviral therapy (ART) within twenty-four hours of an HIV diagnosis is safe, shortens time to viral suppression, improves retention in care, and contributes to reduced HIV transmission at the community level (Bacon et al., 2021). Despite this evidence, patients across the United States do not universally receive timely HIV care (Bertolino et al., 2023). Barriers to early ART initiation include lack of staff buy-in, logistical challenges, and socioeconomic factors affecting patients (Doshi et al., 2023).

LOCAL PROBLEM: A small HIV care clinic in the southern United States observed a similar discrepancy, noting inconsistent timely initiation of …

Exploring The Potential Of Martian Agriculture: Assessing Viability And Nutritional Composition Of Plants Cultivated In Martian Regolith, Abigail Ross

Honors Theses

In addition to sunlight and water, plants can utilize a small number of nutrients from the soil to biosynthesize all the materials that are needed for growth and development. However, plants require an environment where they are able to obtain those nutrients, such as iron, magnesium, potassium, sulfur, and nitrogen. Environmental factors determine the types and accessibility of nutrients available to plants. Plants then take up these nutrients from the soil to aid in biological mechanisms and the synthesis of important molecules needed for growth and development. Ascorbic acid, commonly known as Vitamin C, is a vital molecule that is …

Dopaminergic Regulation Of Aversive Motivation, Elaine M. Grafelman

Dissertations (1934 -)

We all experience adversity in our lives, and we must be able to effectively respond to these challenges in order to thrive. One way to respond to stressors is to change one’s behavior to cope with the stress. This can include escaping or avoiding the stressor, focusing effort to diminish the effect of the stressor, or other coping strategies such as drug use. In fact, stress is one of the principal triggers of relapse for those in the abstinence phase of a substance use disorder and it exacerbates a variety of other disorders. Therefore, it is critical to understand the …

Quality Improvement Project: Trauma-Informed Care For Nurse Faculty, Nicke R. Wilson

Doctor of Nursing Practice Projects

Recent research in nursing education highlights trauma-informed care, noting that nurse faculty often understand the concept but lack formal training to apply it consistently. The Doctor of Nursing Practice (DNP) project aimed to address this gap by developing an evidence-based Trauma-Informed Care training module to help faculty acquire the skills needed for psychologically safe and inclusive learning environments. This initiative aligned with the priorities of the American Association of Colleges of Nursing. Trauma-informed care is especially important in high-stress fields like nursing, where trauma can impact the performance, engagement, and well-being of both students and faculty. The project, conducted at …

Quality Improvement Project: Enhancing Nursing Documentation Of Patients’ Chief Complaints And Anatomical Site Markings In Radiographic Imaging Requests, Clara Odili

Doctor of Nursing Practice Projects

Incomplete or inaccurate radiographic imaging requests remain a persistent barrier to diagnostic accuracy and patient safety in urgent care settings. The purpose of this quality improvement (QI) initiative was to enhance nursing documentation of patients’ chief complaints and anatomical site markings through an evidence-based educational intervention targeting nurse-trained X-ray technicians. Guided by Benner’s Novice-to-Expert framework and principles of evidence-based practice, this project employed a pre- and post-intervention design over a two-week implementation period. Data was collected using structured knowledge and competency assessments. Post-intervention findings demonstrated substantial improvements in documentation accuracy, with mean knowledge scores increasing by approximately 30% and self-reported …

Improving Lung Cancer Screening Rates Through Low-Dose Computed Tomography, Pauline Adhoch

Doctor of Nursing Practice Projects

Tobacco use is the leading cause of lung cancer and one of the most preventable causes of morbidity and mortality worldwide. The World Health Organization estimates that 1.25 billion people smoke, resulting in significant social, economic, and health burdens. Despite this, opportunities to screen and refer eligible patients for lung cancer screening are often missed in primary care, contrary to the recommendations of the United States Preventive Services Task Force (USPSTF). This quality improvement (QI) project educated clinical staff about the USPSTF guidelines for lung cancer screening to increase referral rates. Lewin’s Change Model guided behavior change, and the Iowa …

Quality Improvement Project: Nursing Faculty Mental Health Literacy Assessment And Evaluation, Elesha Roberts

Doctor of Nursing Practice Projects

Mental illness is a major healthcare concern affecting young adults enrolled in college. College students enrolled in nursing programs in particular face intense academic pressure due to the demands and rigor of the program. Students commonly report symptoms associated with depression, anxiety, and suicide. Nursing faculty often do not feel comfortable approaching students about these concerns and other related mental health issues. Many faculty members lack the knowledge and skill to identify mental health issues and provide resources to support students in need. Faculty should be mental health literate and aware of campus resources. The purpose of this quality improvement …

Compensation Transparency In The U.S. Healthcare Workforce, Brandon Perkins

Honors Projects

This study investigates how perceptions of pay transparency among U.S. healthcare workers relate to work engagement, burnout levels, and intentions to stay with their current institution. A quantitative survey was conducted of 200 clinical and non-clinical employees across academic, nonprofit, for-profit, and government healthcare organizations. Self-reported views of transparency were evaluated in relation to validated measures of work engagement, burnout, stay intentions, and pay secrecy. The results showed that increased perceived compensation transparency was highly connected with greater work engagement and lower levels of burnout. Both engagement and burnout appeared as major indicators of the employees' intentions to stay with …

Quality Improvement Project: Provider Education On An Evidence-Based Clinical Pathway For Diagnosing Adult Attention-Deficit Hyperactivity Disorder, Oluwadayo B. Adeyemo

Doctor of Nursing Practice Projects

Accurate diagnosis of adult Attention-Deficit Hyperactivity Disorder (ADHD) remains challenging in outpatient behavioral health settings, as variations in clinician training, diagnostic tools, and assessment methods can hinder accuracy and delay treatment. At the project site, providers reported low confidence and inconsistent use of standardized tools when evaluating adult ADHD, underscoring a critical need for structured education to improve diagnostic consistency and provider confidence. This quality-improvement (QI) project assessed the impact of an educational intervention on provider knowledge, confidence, and utilization of validated screening tools for adult ADHD. Guided by Donabedian’s Model of Quality Improvement and Lewin’s Change Theory, the project …

Quality Improvement Project: The Impact Of Genetic Testing Education For Mental Health Providers In An Outpatient Clinic, Ifeoma Uzoh-Anigbogu

Doctor of Nursing Practice Projects

Despite growing evidence supporting the use of genetic screening in psychiatric medication management, many mental health providers lack the confidence and knowledge to utilize this tool effectively. This quality improvement (QI) project aimed to enhance provider self-efficacy and increase the utilization of genetic screening through a structured education and training program in an outpatient mental health clinic. The purpose of the project was to determine whether provider education on pharmacogenetic testing improves confidence and screening frequency compared to those who do not receive the intervention. The Donabedian Model guided evaluation of structure, process, and outcome measures, while Rogers’ Diffusion of …

Quality Improvement Project, Communicating With The Dying Patient: A Simulation Experience For Nursing Students, Jason Weger

Doctor of Nursing Practice Projects

Effective communication with patients near the end of life is a crucial yet often underdeveloped skill among nursing students. Previous research highlights a persistent gap in training for end-of-life communication in nursing schools. This quality improvement project implemented a simulation-based educational intervention to improve end-of-life communication skills among first-semester nursing students at a community college in Oklahoma. A needs assessment identified significant gaps in students' readiness for emotionally charged patient interactions. Guided by Prosci’s Change Model and Jeffries Simulation Theory, the project used a faculty-led simulation experience to teach evidence-based communication strategies, including appropriate word choice, therapeutic presence, and active …

Quality Improvement Project: Reducing Hospitalizations In The Long-Term Care Setting, Nenna Nzeocha

Doctor of Nursing Practice Projects

Hospitalizations in the long-term care setting can lead to higher costs incurred by skilled nursing home residents and a poorer quality of life. This quality improvement (QI) project evaluated whether an educational intervention on the Reducing Avoidable Facility Transfers (RAFT) model impacted hospitalization rates in the skilled nursing facility (SNF), while also assessing the confidence level of facility staff on the intervention. The project utilized Lewin’s change theory and the Donabedian model framework and was aimed at developing interventions that impact hospitalizations in the SNF using the RAFT model. A quasi-experimental design was used and consisted of a pre-and-post implementation …

Quality Improvement Project: Development And Implementation Of A Structured Certification Support Program And The Impact On Nurses’ Confidence And Medical Surgical Certification Rates, Mary Tran

Doctor of Nursing Practice Projects

Professional nursing certification is an important criterion of Magnet designation, and increased certification rates have been associated with positive patient outcomes. The literature supports peer support and group study as beneficial strategies to assist nurses in preparing for certification exams. A quality improvement project among medical-surgical (med-surg) nurses at a community hospital pursuing Magnet redesignation addressed the lack of formal processes and nursing perceived barriers to certification that may contribute to low certification rates. The purpose of this project was to develop and implement a structured medical-surgical certification support program following the Plan-Do-Study-Act (PDSA) cycle utilizing evidence-based strategies, including a …

Quality Improvement Project: Improving Nurse Competency In Caring For Patients With Dementia With Behavioral Disturbances In Long-Term Care, Lashunta Jackson

Doctor of Nursing Practice Projects

Dementia-related behavioral and psychological symptoms (BPSD) present major challenges for nurses in long-term care settings, often leading to inconsistent care, staff stress, and safety risks. Evidence-based, person-centered interventions are proven to improve outcomes but are frequently underutilized due to limited staff training. The purpose of this Doctor of Nursing Practice (DNP) project was to improve nursing staff competency in managing residents with dementia and behavioral disturbances through structured, evidence-based education. The problem identified was a lack of dementia-specific knowledge and confidence among nurses, which contributed to suboptimal care and increased behavioral incidents. A quasi-experimental pre-/post-intervention design guided by Knowles’ Adult …

Improving Self-Efficacy Among Clinical Instructors: The Impact Of Communication Education On Handling Lateral Violence, Emma Guidry

Doctor of Nursing Practice Projects

The quality improvement (QI) project aims to determine if clinical instructors perceive changes in self-efficacy in communication skills specific to lateral violence (LV) situations secondary to an educational intervention. Currently, clinical nurse instructors lack education specifically addressing communication strategies to utilize when LV occurs in the clinical setting. Banduras Social Cognitive Theory, Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) were employed as frameworks in the development of this project. Methods used in this quasi-experimental design project include administration of the Self Efficacy to Address Disruptive Behaviors Scale (SADBS) survey to project participants, nursing clinical instructors. The evidence-based practice (EBP) intervention …

Resiliency For Nurse Educators: Incorporating Resiliency Training For Nursing Faculty, Rachael Holder

Doctor of Nursing Practice Projects

Nursing faculty frequently experience high levels of stress, workload demands, and burnout, which can negatively affect teaching effectiveness and retention. Literature supports resilience as a protective factor that enhances well-being and professional sustainability. The purpose of this quality improvement project was to impact resilience levels among full-time undergraduate nursing faculty through a self-paced online resiliency training program. Guided by Pender’s Health Promotion Model and Lewin’s Change Theory, this pre- and post-intervention design used the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to assess changes in resilience. Eleven faculty members completed the pre-survey, and two completed the post-survey. The post-survey mean CD-RISC-10 scores …

Quality Improvement Project Implementation Of A Peer Mentoring Program In An Associate-Degree Nursing Program, Heather Baker

Doctor of Nursing Practice Projects

Peer mentoring is recognized as an evidence-based strategy that offers support to students and enhances retention. This project aimed to implement a peer mentoring program based on the Nursing Universal Retention and Success (NURS) model. The Plan-Do-Study-Act (PDSA) framework and Havelock’s Theory of Planned Change guided the implementation process. The goal was to assess the program's impact on first-semester nursing student retention rates and students’ perceptions of success. First-semester nursing students in a traditional associate-degree nursing program volunteered to participate in the peer mentoring program for one semester. At the end of the semester, an anonymous post-survey was distributed to …

Quality Improvement Project: Improving Emergency Medication Administration Safety In An Inpatient Psychiatric Unit, Sandra Anusiem

Doctor of Nursing Practice Projects

Psychiatric emergencies contribute to medication safety issues due to increased stress, inconsistent practices, and communication breakdowns. The problem was high rates of medication errors in psychiatric emergencies due to the lack of a structured, standardized medication management protocol. This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce medication errors in administering emergency medications in an inpatient psychiatric unit by using the Medication Administration Cross-Check (MACC) checklist. The project was completed using a quasi-experimental research design guided by the Donabedian Model of Healthcare Quality and Lewin’s Change Model. Pretest and posttest knowledge, confidence, attitude, and perceptions were obtained …

Quality Improvement Project: Educating Nursing Faculty On Medication Administration Labs To Improve Student Competency, Chelsea Pacheco

Doctor of Nursing Practice Projects

Medication administration errors are a leading cause of preventable harm in healthcare. Faculty play a critical role in ensuring nursing students develop the knowledge and confidence to give medications safely. A needs assessment at the project site revealed that only course coordinators were teaching medication administration and dosage calculation, leaving other faculty uncertain about how to teach these skills. This quality improvement project aimed to strengthen faculty confidence and create consistency in first-year instruction through a recorded educational video. Constructivist Learning Theory provided the foundation for active, experience-based learning. Lewin’s Change Theory guided the structured implementation process to support adoption …

Quality Improvement Project: Enhancing Diabetes Management Through Continuous Glucose Monitoring Device Education Among Providers Of Underserved Groups, Shaibu Rashid

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance diabetes management among underserved populations by increasing provider confidence and utilization of continuous glucose monitoring (CGM) devices in a Federally Qualified Health Center (FQHC). Despite CGM being recognized as a standard of care for patients requiring intensive insulin therapy, its adoption in FQHCs remains limited due to provider knowledge gaps, financial barriers, and workflow challenges. Based on Kurt Lewin’s change theory, the project employed a quasi-experimental one-group pretest–posttest design to evaluate the impact of an evidence-based educational intervention among six family practice providers. The intervention included interactive sessions on CGM device use, data …

Establishing Nursing Excellence: A Quality Improvement Approach To Nursing Administration Evaluation Using Frontline Feedback, Meredith Sykora

Doctor of Nursing Practice Projects

In the increasingly complex environment of nursing education, leadership quality and responsiveness significantly influence workplace culture, faculty satisfaction, professional development, and student outcomes. Despite these realities, many academic nursing programs, including the Division of Nursing at a community college in Arkansas, lack formal structures for bidirectional leadership evaluation. This gap limits frontline faculty’s ability to provide formative feedback to program leaders, weakening shared governance and transparency. The purpose of this quality improvement project was to evaluate leadership effectiveness following the implementation of a structured bidirectional feedback process between nursing faculty and program leaders. Guided by Kouzes and Posner’s Leadership Practices …

Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah

Walden Dissertations and Doctoral Studies

Abstract In Ghana, the user fee exemption policy, implemented in 2008, provides free maternal health services, which are a key component of the National Health Insurance Scheme (NHIS). Grounded in the Health Access Livelihood Framework, the purpose of this study was to determine the association between the user fee exemption policy and the utilization of antenatal care, facility-based delivery, and postnatal care in Northern Ghana, while controlling for sociodemographic factors. A quantitative approach was employed using secondary data from the Ghana Demographic and Health Surveys, encompassing women of reproductive age (15–49 years; N = 6,948). Logistic regression was used to …

Investigating The Mechanisms By Which Gut Microbiome Dysbiosis Contributes To The Autoimmune Response In Multiple Sclerosis, Abigail Houtrouw

Honors Theses

This literature review explores the multifaceted relationship between gut microbiome (GM) dysbiosis and multiple sclerosis (MS), highlighting key themes that advance understanding of disease pathogenesis and therapeutic potential for treatments targeting the gut. The review underscores the immune system dysregulation in MS, emphasizing the roles of T cells, B cells, and microglia in neuroinflammation and demyelination. Historically, MS pathogenesis was thought to be driven mainly by T-cell dysregulation, but current research highlights the additional roles of B-cells and microglia, the resident immune cells of the central nervous system (CNS). Additionally, this literature review identifies GM alterations and dysbiosis as critical …