Medicine and Health Sciences Commons^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

The Unacknowledged Challenge Of Moral Distress For Nurse Academics, Adam Burston, Glenna Mae Guiriba, Meena Gupta, Sara Bayes

Research outputs 2022 to 2026

The pluralistic nature of healthcare presents nurses with situations challenging their moral values which nurses must navigate. Challenges to moral values can result in the experience of moral distress, a problem that is common within the clinical nursing context. Moral distress is a known and well-researched phenomenon within nursing and has long contributed to detrimental effects such as frustration, anger, anxiety, decreased job satisfaction, burnout and ultimately attrition. However, despite extensive research in clinical environments, minimal research exists detailing this concept within the context of nursing academics and educators. Nurses can experience moral distress if they are in or exposed …

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 …

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 …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Internet Use And Decision-Making Processes Among Pregnant Women: A Cross-Sectional Study, Ayça Balmumcu, Endam Çetinkaya Ak, Sabriye Uçan Yamaç

Makara Journal of Health Research

Background: The coronavirus disease 2019 (COVID-19) pandemic restricted access to in-person health services, especially in rural areas. This increased reliance on the internet for health information and decision-making was particularly notable among pregnant women. This study aimed to investigate the role of internet use in decision-making among pregnant women.

Methods: This analytical, cross-sectional study examined 384 pregnant women living in a rural district of Turkey who attended family health centers for prenatal care. Data were collected using the Internet Decision-Making Scale in Pregnancy and a questionnaire assessing internet use patterns during the pandemic.

Results: Pregnant women demonstrated …

Evaluation Of Implementation Of An Evidence-Based Screening Tool For Genitourinary Syndrome Of Menopause, Anna L. Myers

Doctor of Nursing Practice Projects

Genitourinary syndrome of menopause (GSM) is a prevalent yet underrecognized and undertreated condition despite evidence-based therapies in the urology setting. The purpose of this Doctor of Nursing Practice quality improvement was to provide education on the 2025 American Urological Association/ Society of Urodynamics and Female Pelvic Medicine & Urogenital Reconstruction/American Urogynecological Society GSM guidelines and integrate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire into practice, evaluate outcomes of acceptability, appropriateness, and feasibility of the intervention, and the impact on diagnosis and associated GSM prescribing. The aim was to impact provider screening and treatment of patients with GSM. Kolcaba's Comfort …

Nurse Manager Perceptions Of Strategies To Overcome The Underutilization Of Nonpharmacological Pain Control Methods In Adult Acute Care, Landen M. Bonnell

Undergraduate Honors Theses

A basic patient right is to have pain adequately managed. However, research consistently indicates that many adult patients in acute care experience inadequately managed pain, which may contribute to adverse patient outcomes. Studies have shown that nonpharmacological pain management can lead to increased patient satisfaction, shorter hospital stays, and better patient outcomes. However, many barriers exist to nurses providing effective nonpharmacological pain control therapy, primarily including heavy workload and a lack of education and support. Currently, there is insufficient research on how to overcome these barriers. Four nurse managers with experience in nursing leadership were interviewed using a qualitative descriptive …

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

A Quality Improvement Approach To Reducing Chronic Obstructive Pulmonary Disease Readmissions, Florwisse Rubio

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

The problem identified at the project site is that care transitions for patients with COPD lack standardized discharge processes, leading to inconsistent education, limited follow-up, and poor coordination of care.

Aim of the Project:

The primary aim was to improve patient outcomes by reducing the 19.6% 30-day readmissions among older adults diagnosed with COPD at the selected project site by implementing a standardized discharge intervention over 12 weeks, measuring progress, and ensuring appropriate workflow. The initiative of this project sought to foster a sense of proper continuity of care through timely follow-up, interprofessional communication among patients and providers, and …

Community Health Fair As Experiential Learning: Interprofessional Faculty And Student Perspectives, Sharon Stevenson, Martha Rojo, Jing Jin, Erickson Feliciano, Margaret Love, Scott Wright

Journal of Interprofessional Practice and Collaboration

Abstract

Background: Traditional, precepted clinical practice sites continue to decline. Community health fairs (CHFs), led by experienced interprofessional faculty, present a valuable opportunity. In addition, CHFs provide students with hands-on experience in real-world settings.

Aim: This study examined the perspectives and clinical experiences of interprofessional faculty and students participating in a CHF.

Methods: This study utilized qualitative and quantitative design. Fourteen participants (seven students, seven faculty) engaged in conversational interviews, and completed a faculty and student survey as well as a demographic survey. Descriptive statistics were used to describe the sample and survey responses, and thematic analysis was used to …

Poor Compliance With Private Nursing And Midwifery Practice Guidelines In Urban Settings In Uganda, Dan Muramuzi, Edson Atwine, Barbara Okiror, Mercy Muwema, Christine Nimwesiga, Laban Muteebwa

School of Nursing & Midwifery, East Africa

Background: Optimal compliance with private practice guidelines is one of the core components of quality improvement in nursing and midwifery professions. Private nursing and midwifery practice guidelines in Uganda were introduced in 2019. However, little has been documented about compliance with these guidelines, despite playing a crucial role in ensuring safe nursing and midwifery practice and maintenance of professional standards.  We assessed the compliance with private nursing and midwifery practice guidelines of Uganda (2019) and explored barriers to optimal compliance with these guidelines in private health facilities licensed by the Uganda Nursing and Midwifery Council (UNMC) in Kampala Metropolitan …

Misconduct Among Nurses And Midwives: A Retrospective Descriptive Study Of Cases Handled At The Uganda Nurses And Midwives Council From 2017 To 2021, Barbara Okiror, Christine Nimwesiga, Patience Muwanguzi, Tom Ngabirano, Mercy Muwema

School of Nursing & Midwifery, East Africa

Background: Media reports on the misconduct of nurses and midwives, including cases of fake credentials, drug theft, and incompetence, are on the rise. However, there are no published studies currently addressing this issue in Uganda. Therefore, to inform effective regulation of the profession, we analysed the misconduct cases involving nurses and midwives reported to the Uganda Nurses and Midwives Council between 2017 and 2021.

Methods: The study retrospectively described misconduct cases received and handled at UNMC from 2017 to 2021 and their outcomes. Following total population sampling, data were extracted from case files and then input into a …

Exploring The Role Of Self-Efficacy In Undergraduate Nursing Students: A Transcendental Phenomenological Study, Dorothy Elaine Rolling

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the role of self-efficacy for nursing students whose primary language was not English and who were enrolled in higher education in the northeastern area of the United States. The theory guiding this study was Bandura’s theory on self-efficacy. The major tenets of the self-efficacy theory aligned with the metaparadigm of nursing (person, health, environment, nursing) and with the study’s focus, which was to explore how English as a second language (ESL) nursing students could successfully complete the registered nursing program at an institution of higher learning. The central research question was: …

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …

Be Prepared For Your Nurse Practitioner Clinical Readiness Exam, Elizabeth Heavey, Renee Biedlingmaier, Colleen Burgoyne, Carnel C. Jackson

Milne Open Textbooks

This text contains case studies and review questions for nurse practitioner students; focusing on the 3Ps of nurse practitioner education (Pharmacology, Pathophysiology, and Physical (Health) Assessment) to help NP students prepare for their clinical courses and pass their clinical readiness exam.  It includes cases commonly seen in entry-level NP practice.  In addition to the three individual sections of the text that focus on cases applying content from each of the distinct courses (Pathophysiology, Pharmacology, and Physical Assessment), we included summative case studies at the end of the book that connect all three areas in a single case. Because these three …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

A Survey Of Health Professions Learners’ Attitudes Towards Social Media In Medical Education: A Substance Use Disorders Education Case Study, Gregory A. Jaffe, Sarah Lawson, William Leach, Mallika Kodavatiganti, Erin Avanzato, Katherine Fesperman, Heather Klusaritz

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Social media is a ubiquitous part of the modern world and plays a key role in the dissemination of information. While utilizing social media for educational purposes has been repeatedly demonstrated as feasible, it has been underutilized in medical education and remains a critical opportunity to integrate microlearning and stigma reduction curricula.

METHODS: A cross-sectional survey on social media usage, attitudes, and beliefs was sent to medical and nursing students at two large academic institutions within Philadelphia. Descriptive statistics are reported, and non-parametric tests were utilized for exploratory analyses.

RESULTS: Health learners were low consumers of social media, reporting …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Mental Health Screening For The Military Spouse: Prevention In Practice, Lura Allison Mcgrath

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

In recent years, a focus on mental health has moved to the forefront of healthcare. This is especially true when caring for United States military service members. The military spouses of these service members also struggle and suffer from mental health disorders. However, the mental health needs of military spouses often receive insufficient attention. Research shows military spouses are at an increased risk of developing mental health disorders and/or suffering from mental illness. A large contributor is the impact of the military lifestyle and its challenges for these spouses. However, research also reveals there has been minimal effort put …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Identifying And Addressing Burnout Among Nurses In Cache Valley And The Surrounding Salt Lake Metropolitan Area, Teegan Alma Martinez

Undergraduate Honors Capstone Projects

Background: Nursing burnout has emerged as a critical issue within modern healthcare systems, with widespread implications for nurse well-being, patient safety, and organizational performance. Characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, burnout affects an estimated 30% to 60% of nurses, particularly in high-acuity settings. The persistence of burnout highlights the need to better understand its contributing factors, consequences, and effective strategies for mitigation.

Purpose: The purpose of this study was to examine the prevalence and contributing factors of nursing burnout, evaluate its impact on nurses and patient care, and identify effective interventions. Additionally, this study aimed …

Discharge Process Improvement Initiative Using An N-By-T Strategy In A Progressive Care Unit In An Acute Care Setting, Sukhvir Walia

Doctor of Nursing Practice Projects

Background

Timely and efficient patient discharge processes are crucial for enhancing hospital throughput, reducing emergency department boarding, optimizing inpatient bed utilization, and ensuring safe transitions of care. Delayed hospital discharges contribute to prolonged hospitalizations, operational inefficiencies, increased healthcare expenditures, and decreased patient satisfaction. Progressive care units (PCU) are particularly vulnerable to discharge delays because patients frequently require multidisciplinary coordination before safe discharge can occur.

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of implementing a structured discharge readiness checklist combined with an n-by-T discharge planning strategy during multidisciplinary patient progressive rounds (PPRs) to improve discharge …

Barriers To Climate Change And Sustainability Action: Nursing Education And Practice, Dawn Marie Smith

Dissertations

Climate change is one of the most pressing public health emergencies of our time and nurses can have a great impact in their current practice and in the education of future nurses (The Alliance of Nurses for Healthy Environments, n.d.; American Nurses Association, 2023; Health Care without Harm, 2025). Deaths due to rising temperatures, vector-borne illness, and food insecurity related to drought and extreme weather are on the rise (WHO, 2024). It has been estimated that globally over 250,000 additional deaths will be attributed to climate related effects between 2030 and 2050 (Watts et al., 2020; WHO, 2023).

A primary …