Medicine and Health Sciences Commons^™

Quality Improvement Project: Empowering Nurse Educators: Implementing A Mentoring Program For Professional Growth, Sarah Sugg

Doctor of Nursing Practice Projects

With the ongoing nursing shortage, nursing education plays a vital role in shaping the future of healthcare through the preparation of competent and skilled nurses. Literature supports that a persistent challenge within nursing academia is the lack of structured mentoring programs to support novice nursing faculty transitioning into academic roles. This quality improvement project addressed this gap through the implementation of a structured, evidence-based mentoring program compared to informal mentoring. The purpose of the project was to empower novice nursing faculty with less than three years of teaching experience by enhancing teaching competence, confidence, job satisfaction, and retention. Guided by …

Quality Improvement Project: Increasing Breast Cancer Screening Rates Among Women Ages 40-74 At A Federally Qualified Health Center By Implementing A Provider Alert Tool, Tiny Stephens

Doctor of Nursing Practice Projects

Breast cancer maintains its position as the leading cause of cancer-related death for women worldwide and remains the second deadliest cancer among female patients in the United States (Centers for Disease Control, 2024). The screening rates at Federally Qualified Health Centers (FQHCs), which serve medically underserved communities, remain lower than national benchmarks, thus putting their patients at risk for receiving late-stage cancer diagnoses. This quality improvement project implemented an evidence-based electronic medical record (EMR) provider alert tool at a Northeast Georgia FQHC to address a baseline mammogram order compliance rate falling below national standards at 45%. The project aimed to …

Quality Improvement Project Nursing Student Retention Strategies: A Focus On Peer Mentoring, Anh Vittoria

Doctor of Nursing Practice Projects

The nursing shortage remains a concern in healthcare. Increasing the number of students who complete nursing programs and enter the profession can help with the demand for nurses in the workforce. Nursing programs face challenges with student retention, which limits the number of nurses entering the profession. The quality improvement project aimed to examine the effects of a peer mentorship program on first-year associate degree nursing students’ perception of support and course completion rates. The purpose is to impact student retention and sense of support in an Associate Degree Nursing Program (ADN) through peer mentorship. The project was guided by …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Enhancing Mental Health Providers' Approach To Medication Adherence In Schizophrenia Patients Using Motivational Interviewing Techniques., Jacinta Madu

Doctor of Nursing Practice Projects

Medication non-adherence among individuals with schizophrenia remains a persistent challenge that undermines symptom management and increases relapse and hospitalization rates. This quality improvement (QI) project aimed to evaluate the effect of Motivational Interviewing (MI) training on provider knowledge and confidence in promoting medication adherence within an outpatient mental health clinic. Guided by Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) framework, a quasi-experimental pre–post design was used. Six providers, including psychiatric nurse practitioners, therapists, a psychiatrist, and a registered nurse, participated in a structured MI training session incorporating didactic instruction and role-play exercises. Data were collected using pre- and post-intervention surveys …

Quality Improvement Project: Effect Of Multi-Level Student Collaboration On Clinical Judgment In High-Fidelity Simulation, Jillian Carroll

Doctor of Nursing Practice Projects

There is a gap in undergraduate nursing curriculum on incorporating collaboration and communication into patient care, leading to a lack of competence and confidence in novice practice. Using collaboration in high-fidelity simulation, students gain real-world exposure and opportunities to communicate and make independent decisions. Using Kotter’s eight-step change theory, this project addresses the limited exposure to collaboration by implementing purposeful interdisciplinary collaboration within high-fidelity simulation to improve undergraduate nursing students’ confidence and competence in nursing practice. This will build on Patricia Benner’s novice-to-expert theory and help advance Associate Degree Nursing (ADN) students into a safe and effective novice year of …

Quality Improvement Project: Impact Of A Brief Mindfulness-Based Stress Reduction Program For Healthcare Providers Who Evaluate Veterans, Peng Anderson

Doctor of Nursing Practice Projects

Long-term stress can lead to healthcare provider burnout. Mindfulness-based interventions, even when shortened, may provide a promising and innovative method to reduce stress and prevent burnout. Research on mindfulness programs has demonstrated significant benefits for both providers and patients. This quality improvement project aims to evaluate the effect of a brief mindfulness-based stress reduction program (MBSR) for providers who evaluate veterans on the variable of mindfulness awareness compared to current site practice. Lewin’s change management model and Peplau’s Interpersonal Relations Theory were used. Plan-Do-Study-Act was the implementation framework applied. The design was pretest-posttest using the Mindful Attention Awareness Scale (MAAS). …

Parental Experiences With Financial Toxicity In The Pediatric Intensive Care Unit: A Phenomenological Research, Sohrab Alexander Sardual

Dissertations and Theses (Open Access)

Background: Parents of children admitted to the pediatric intensive care unit (PICU) encounter multiple stressors; however, there is a need to further understand their experiences with financial toxicity. Understanding parents’ experiences and perspectives on how they can be assisted is a critical first step to formulating interventions to help parents deal with financial toxicity.

Aims: The aims of this study are (a) to describe the experiences with financial toxicity of parents with critically ill children admitted to the PICU and (b) to explore parents’ perspectives on how they can be assisted in dealing with financial toxicity.

Methods: A phenomenological qualitative …

Benefits Of Animal Assisted Therapy In Pediatric Inpatient Units: A Literature Review, Logan M. Shiflett

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review of literature was to establish if animal assisted therapy (AAT) is helpful in the reduction of stress for patients on pediatric inpatient floors. The PICOT question that led this review was: In pediatric patients, how does animal assisted therapy affect patient outcomes related to increased hospitalizations? The EBSCOhost database, as well as the Web of Science and CINAHL Complete information sources, were used to find relevant studies for this review that assessed the benefits and contraindications for AAT. Key terms such as “animal assisted therapy,” “pediatrics,” and “inpatient” were used to narrow down the …

A Comparison Of Cultural Aspects Of Breastfeeding In The United States Vs Italy, Madison P. Wallace

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Healthcare systems internationally differ from policies, funding and resources available, and it is evident when comparing the United States and Italy. Participation in the Nursing Across the Lifespan study abroad program at the University of Arkansas Rome Center and Tiny Tusk Breastfeeding and Infant Support internship inspired a comparative exploration of breastfeeding practices in the United States versus. Italy. The United States has a mixed public- private insurance system, workplace policies and government assistance, while Italy has a universal healthcare system with a mandated maternal work paid leave to support breastfeeding mothers. Italy's program supports education and physical care needed …

Exercise As A Treatment For Depression And Anxiety Symptoms In College Students, Ashley J. Fountain

ATU Honors Projects

Anxiety and depression have become increasingly prevalent among college students, with rates rising to levels that demand urgent and accessible treatment alternatives. Traditional interventions such as psychotherapy and pharmacological treatments, while effective for many, present limitations including high cost, side effects, and barriers to access. This paper examines exercise as a holistic, evidence-based treatment modality for reducing symptoms of depression and anxiety in college students. Recent research demonstrates that aerobic exercise, resistance training, and yoga each produce meaningful physiological and psychological benefits through mechanisms involving neurotransmitter regulation, reduced cortisol levels, and enhanced self-esteem. Studies comparing exercise with antidepressant medications show …

Navigating Upstream: How Medical Educators Strategize The Unfamiliar During Their Transition Into A Leadership Role, Sarah Williams

LSU New Orleans Theses and Dissertations

As the medical field grows more complex, the need for medical educator leaders has increased, driving the integration of leadership training into medical education to help manage an increase in administrative challenges. In U.S. medical schools, the Liaison Committee on Medical Education (LCME) standards require faculty to fill high-ranking leadership roles who must balance academic and administrative duties. Medical educators in these leadership roles must manage the tensions between teaching, research, patient care, and administrative responsibilities. Although leadership programs designed for medical educators exist, as well as faculty development opportunities, educators consistently express a lack of training as they transitioned …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

LSU New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Understanding Hepatitis C Risk And Harm Reduction Needs Among People Who Smoke Drugs: A Client-Centered Qualitative Inquiry, Maxwell Gustin

Anthropology

The spread of Hepatitis C virus (HCV) via non-injectable equipment is plausible, making people who smoke drugs (PWSD) at-risk for possible infection and transmission. While much research has been conducted into injection drug use (IDU), likely due to the rising opioid epidemic, limited studies focus on the risks PWSD face. Currently, state-funded syringe service programs (SSPs) provide harm reduction education and materials to combat these risks. Safer smoking initiatives have been created and are widely used by PWSD, and have access to SSPs. To gain better insight into the HCV and non-HCV-related risks and burdens PWSD face, a qualitative study …

Acceptance And Commitment Therapy As A Transdiagnostic Approach To Improve Quality Of Life Among Adults Living With A Physical Chronic Health Condition, Marissa L. Donahue

All Graduate Theses and Dissertations, Fall 2023 to Present

The research contained in this dissertation presents rationale and empirical support for the application of acceptance and commitment therapy (ACT) as a transdiagnostic approach in improving quality of life for adults living with chronic health conditions (CHCs). The first study consists of a systematic review that aims to examine (1) the current state of evidence of ACT for adults living with a CHC, (2) how outcomes are being characterized within this population, (3) the methodological quality of the included trials, as well as (4) summarizing the health conditions in which ACT has been evaluated for. The second study examines the …

Injury Prevention And Care Training Website, Samantha E. Myers

Theses/Capstones/Creative Projects

Injury Prevention and Care is a University of Nebraska Omaha (UNO) resource within Campus Recreation and Wellness. It serves a variety of students, staff, , and other membership holders with a variety of resources and treatments in caring for injuries and in seeking to prevent new or worsening of injuries. In facilitating the health and growth of this department and their staff, updating the current training resources, and making them more accessible was necessary. Moving forward, discussions of the importance of accessibility and providing various resources, both in IPC and across the UNO campus, were pivotal in the formation and …

Comparative Analysis Of The Effects Of Peppermint Oil On Colorectal Cancer Cells And Human Fibroblasts, Allen W. Mccumbers

Theses/Capstones/Creative Projects

This study contrasted the effects of Peppermint Oil on two cell lines, HT29s (colorectal adenocarcinoma cells) and HFFs (Human Foreskin Fibroblasts). Cytotoxic as well as genomic effects were compared between the cell lines. Trypan Blue, Alamar Blue, and qPCR assays were used to study these effects. Both cell lines were treated with a range of Peppermint Oil concentrations, and it was determined that there is a dose-dependent factor associated with cytotoxicity. To confirm results, Alamar and Trypan Blue assays were repeated at 300 and 500 cells/mL respectively. Effects were confirmed, and results were averaged and plotted. Alamar Blue revealed that …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Advancing Anesthesia Provider Proficiency In Airway Assessment Using Point-Of-Care Ultrasound: An Osce-Based Educational Initiative, Austin Fike, Trevor Jordan, Sam Sherrill Iii

Doctoral Projects

Airway management is one of the fundamental pillars of anesthesia. Traditionally, tools such as the Mallampati classification and the thyromental distance are used for airway assessment in the perioperative area. However, often, these methods fail to reliably predict difficult intubations. The use of point-of-care ultrasound (POCUS) has emerged as a valuable adjunct in airway assessment. However, a knowledge deficit exists among anesthesia providers regarding its application in airway assessments for perioperative adult patients. This doctoral project addressed the knowledge deficit in POCUS airway assessment among Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) through the development and …

From Awareness To Action: Improving Advanced Directives With The Five Wishes In College Aged Young Adults, Dina M. Giovanetti

Electronic Theses and Dissertations

This quality improvement project aimed to increase early education, initiation, documentation, and completion rates of advance directives (ADs), specifically the Five Wishes, among college-aged young adults (18–24 years old) in a concierge primary care setting. The project addressed the low engagement and completion rates of ADs in this population, which can result in inadequate end-of-life care planning. The initiative involved training all staff members through collaborative instruction, informational sessions, and personalized provider-patient discussions. A convenience sample of eligible patients was identified via chart review. Inclusion criteria included English-speaking young adults aged 18–24, regardless of comorbid conditions who were members of …

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

Exploring Factors Informing The Choice Of Caesarean Sections Among Couples, And Healthcare Workers: A Case Of The Nairobi Hospital, Kenya, Mercy Mukubwa

MSc in Advanced Practice Midwifery

Background: A caesarean section (C/S) is a lifesaving procedure to reduce maternal and newborn morbidity and mortality. It is associated with more risks compared to a vaginal birth. The rates of C/S have been on an upward trend globally and are expected to continue to rise further. C/S predisposes neonates to poor outcomes, some of which could be life-threatening compared to vaginal birth. Similarly, C/S mothers are at greater risk for serious complications.

Objective: The primary objective of this study was to investigate the factors influencing the decision to undergo a caesarean section among couples and healthcare workers …

Lived Experiences Of Chemotherapy-Induced Nausea And Vomiting Among Patients Diagnosed With Cancer At Machakos Level Five Hospital, Nancy Njeri Kamau

MSc in Advanced Practice Nursing

Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the most prevalent and distressing adverse effects of cancer treatment, affecting a substantial proportion of patients and significantly compromising their physical functioning, nutritional status, treatment adherence, and overall quality of life. However, there is a paucity of localized evidence on the magnitude and functional burden of CINV among patients diagnosed with cancer receiving chemotherapy at county referral hospitals, such as Machakos Level 5 Hospital, hence the current study.

Aim of the study: The study aimed at exploring the lived experiences of chemotherapy induced nausea and vomiting among patients diagnosed with …

Improving Early Detection Of Suicidal Ideation Through Routine Screening In Adults With General Anxiety Disorder, Brittanie N. Bush

Doctor of Nursing Practice

Suicide is a leading cause of death in the United States, with anxiety and depression recognized as independent risk factors for suicidal ideation (Centers for Disease Control and Prevention, 2024 September 26; Grant et al., 2023; Li et al., 2022; Moon et al., 2025; Wiebengo et al., 2021). Incorporating valid screening tools like the General Anxiety Disorder-7 and the Columbia-Suicide Severity Rating Scale can help identify suicidal ideation early, enabling quicker provider intervention (Johnson et al., 2019; O’Connor et al., 2022). The purpose of this project was to implement the Columbia-Suicide Severity Rating Scale as a standardized screening tool for …

Enhancing Adherence To Veterans Affairs/Department Of Defense And American Psychiatric Association Clinical Guidelines For Alcohol Use Disorder, Corinna M. Trevino

Doctor of Nursing Practice

Alcohol use disorder continues to be significantly undertreated within outpatient behavioral health settings, particularly concerning pharmacological interventions. Despite the presence of robust national clinical guidelines recommending medications such as naltrexone for individuals with moderate to severe dependence, the rates of prescribing these medications remain modest owing to inconsistent screening procedures, limited referral practices, and provider follow-through barriers. This project was implemented at a substance use treatment center in a large metropolitan area to improve adherence to clinical practice guidelines. The purpose of this project was to increase prescribing of naltrexone and improve referral for patients with moderate to severe alcohol …

Balancing Act: Examining The Relationship Between Organizational Culture And Burnout Within Graduate Medical Education Program Coordinators, Michael Conrad

Graduate Theses and Dissertations

This phenomenological study examined the lived experience of working as a graduate medical education (GME) program coordinator to determine how organizational culture impacts their burnout. The study was guided by the Job Demand-Resource Theory and the Conservation of Resources theory. When job demands outweigh job resources for an individual for a long period of time, it can result in burnout. Job resources can be used to buffer against demands and promote job growth, engagement, and learning. It is this concept which leads individuals to protect their resources when needed and to strive to develop new resources. Data was collected through …

Determinants Of Mental Health-Seeking Behaviour Among Upgrading Nursing Students At The Aga Khan University, Kenya, Cecilia Wanjiru Ndungu

MSc in Advanced Practice Nursing

Background: Mental health challenges are increasingly recognised, and nursing students often report higher stress and anxiety than other peers.Working nurses in upgrading programmes face additional pressure from balancing work, study and family,yet remain under-studied. At Aga Khan University in Kenya, the determinants influencing mental health-seeking behaviour among upgrading nursing students have not been documented, which is critical for addressing mental health needs. This study aimed to investigate the biological, psychological, and sociological factors influencing mental health-seeking behavior in this cohort.

Methodology: A descriptive cross-sectional study was conducted among 106 upgrading nursing students at AKU, utilizing structured questionnaires to …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …