Nursing Commons^™

Quality Improvement Initiative To Improve Adherence To Ob Hemorrhage Policy And Standardize Pitocin Administration During Cesarean Sections To Reduce Postpartum Hemorrhage Risk, Lauren R. Litz, Monica Blauser

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality, and Pitocin administration is an important component of hemorrhage prevention and management during cesarean delivery. Variation in Pitocin timing, dosing, method of administration, and adherence to evidence-based recommendations may compromise patient safety and create barriers to standardized obstetric anesthesia care. The purpose of this Doctorate of Nurse Anesthesia Practice quality improvement project was to evaluate current anesthesia provider practices for Pitocin administration during cesarean delivery, compare observed practices with the California Maternal Quality Care Collaborative hemorrhage toolkit and Society for Obstetric Anesthesia and Perinatology Enhanced Recovery After Cesarean recommendations, …

Bridging The Gap In Science Research: Preparing Students For College- Level Research In The Sciences, Victoria Helwig, Yaoguang Li

UConn Library Presentations

Many first-year students enter college unprepared to fully engage with scientific literature and academic library resources. Drawing on experiences from academic librarians working with STEM students, this session explores common gaps in science research skills, including navigating databases, identifying scholarly sources, and understanding the structure of scientific literature. Participants will be introduced to practical strategies and classroom-ready activities to better prepare students for college-level research. Discussion questions: What science research skills do students struggle with most when entering college? How can high school instruction better support these skills? Where can librarians and educators collaborate to support student success?

Surviving Sepsis 2026: Key Updates, Amanda Rawa, Katherine Ghattas

Transformative Medicine

The 2026 update to the Surviving Sepsis Campaign guidelines introduces several important changes in the management of sepsis and septic shock, with a greater focus on tailoring treatment to individual patients. Notable updates include lower blood pressure targets for older adults with septic shock, continued support for early fluid resuscitation, the selective use of rapid diagnostic testing to guide antibiotic therapy, and increased flexibility in vasopressor selection for patients with cardiac dysfunction. These recommendations are based on emerging evidence aimed at improving patient outcomes while reducing unnecessary interventions and treatment-related complications. Overall, the updated guidelines reinforce a more personalized approach …

Nurses’ Knowledge Regarding Ventilator-Associated Pneumonia Prevention Bundle In Adult Cardiac Care Units, Marwa Abdo

Nursing

Ventilator-associated pneumonia (VAP) is among the most common ICU infections for ventilated patients, associated with increased mortality (20-50%), morbidity, and health care costs. Nurses' knowledge of VAP prevention bundles is vital to reducing its incidence in critical care areas. Aim: To assess Nurses’ knowledge regarding the ventilator-associated pneumonia prevention bundle in Adult Cardiac Care Units. Study design: A cross-sectional study design was used. Setting: This study was conducted in both the adult cardiac intensive care unit and the cardiac care unit at Aswan Heart Centre–Magdy Yacoub Foundation, Egypt. Subject: A convenience sample of 67 nurses was selected. Data collection tool: …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Dexmedetomidine And The Prevention Of Emergence Agitation In Military Veterans With Post-Traumatic Stress Disorder, Taylor P. Ranegar

Doctor of Nursing Practice Scholarly Projects

Emergence agitation (EA) is a post-anesthetic complication that occurs when the patient is in a self-limited, nonfluctuating state of excitement while transitioning into a state of consciousness. EA can lead to negative adverse outcomes including, accidental invasive line removal, bleeding, respiratory depression, unintentional extubation, and injury to the staff and the patient. EA is often observed in military veterans who have a medical history of post-traumatic stress disorder (PTSD). For patients with a history of military exposure undergoing elective general anesthesia who also have PTSD, anxiety, and or depression, the incidence of EA was estimated to be around 27%. The …

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

The Relationship Between Mc1r Gene Variants For Red Hair And Clinical Responses To Anesthesia, Analgesia, And Pain: A Systematic Review Of The Literature, Mary Clark Allen

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Genetic variations of the melanocortin-1 receptor (MC1R) are commonly associated with red hair and pale skin. Research has linked MC1R variants with alterations in anesthetic response, pain perception, opioid sensitivity, and pain-related fear. Existing literature presents inconclusive findings, highlighting the need for further investigation.

Purpose: This review aims to synthesize current evidence concerning the role of MC1R variants in altering physiologic responses.

Methods: A systematic literature review was conducted by accessing CINAHL, MEDLINE, and PubMed through the University of Arkansas Libraries OneSearch platform. After applying inclusion and exclusion criteria, a total of 20 peer-reviewed articles were extracted for review. …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Efficacy And Safety Of Stem Cell-Based Interventions For Burn Wound Healing: A Systematic Review And Meta-Analysis Of Pre-Clinical And Early Clinical Evidence, Prayuth Poowaruttanawiwit, Patsanan Kulla, Naveeya Pakpoomkamonlert

The Thai Journal of Pharmaceutical Sciences

Background: Burn injuries remain a major therapeutic challenge, with conventional treatments often failing to achieve complete functional skin regeneration. Stem cell-based interventions, including mesenchymal stem cells (MSCs) and exosome derivatives, have demonstrated regenerative and immunomodulatory potential, yet their translation to clinical practice remains limited.
Objectives: To systematically evaluate the efficacy and safety of stem cell-based therapies for burn wound healing across pre-clinical and clinical studies.
Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, four databases (PubMed, Embase, Scopus, and Cochrane) were searched through April 2025. Eligible studies included randomized controlled trials and controlled pre-clinical …

Hybrid Diabetes Coaching Model: Integrating In-Person And Telemedicine Strategies To Improve Glycemic Outcomes, Sandis A. Mundackal

Student Scholarly Projects

Practice Problem: In patients with type 2 diabetes, poor glycemic control among adults remains a significant challenge in primary care settings, particularly within federally qualified health centers (FQHCs) that serve underserved populations. At the FQHC practice site, patients were managed using standard care with quarterly follow- up visits, without a structured hybrid coaching approach. This inconsistency contributed to a high number of patients with hemoglobin A1c (HgbA1c) levels ≥ 9%, placing them at increased risk for diabetes-related complications.

PICOT Question: In adults with poorly controlled type 2 diabetes (HgbA1c ≥ 9%) (P), does monthly hybrid coaching delivered through in-person and/or …

Creating A Culture Change Around Stroke: Integrating Process Improvement To Reduce Door-To-Needle Time, Shayna Brewer, Benedict Pereira, Rose Bisellach, Jason Greenspan

Providence Nursing Research Conference 2023 – Present

No abstract provided.

A Study Of Awareness Of Antiseptics And Disinfectant Use Among Allied Health Sciences Students And Interns Of A Tertiary Care Hospital, Pooja M, Puneeth A, Sharmi Nm

Digital Journal of Clinical Medicine

Background:

Antiseptics and disinfectants are among the most vital tools in infection prevention and control (IPC), especially in healthcare settings where the risk of hospital-acquired infections (HAIs) remains a significant concern. This study aims to assess the awareness and knowledge of antiseptics and disinfectants among Allied Health Sciences (AHS) students and interns, identify knowledge gaps at different stages of training, and recommend educational interventions.

Methods:

This was a cross-sectional, questionnaire-based study conducted among 1st to 3rd-year AHS students and interns at a tertiary care hospital. Data were collected using a validated questionnaire via a Google form after obtaining approval from …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Asthma Integrative Review: Effects Of Aerobic Exercise On Asthma Exacerbation, Abigail Williams, Dazya Crayton, Nicole Stasiak, Sabrina Stich

Master's Projects

Asthma is a chronic respiratory illness defined by airway inflammation and episodes of exacerbation. Pharmacological intervention remains the treatment of choice; however, there is growing evidence to support moderate intensity aerobic exercise as adjunct therapy to promote asthma control. The integrative review evaluates current evidence supporting the PICO question: In adults with mild to moderate asthma, what is the effect of prescribed aerobic exercise on reducing exacerbations? A systematic search of CINAHL, Health Source: Nursing, MEDLINE, and PubMed identified eligible studies. The inclusion criteria required peer-reviewed quantitative articles written in English and published within the past five years. In addition, …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Global Prevalence Of Hyperhomocysteinemia Among Adults With Hypertension: A Narrative Review, Wangkheimayum Ashalata Devi Phd Scholar, Dr. Melita Sheilini Associate Professor, Dr. Rinchen Doma Bhutia Assistant Professor, Corresponding Author: Dr.Melita Sheilini, Associate Professor,Department Of Medical-Surgical Nursing, Manipal College Of Nursing, Manipal Academy Of Higher Education, Manipal, Udupi District, Karnataka, India.Contact Number- 8095976561. Email Id: [email protected]

Manipal Journal of Nursing and Health Sciences

Background: Elevated blood homocysteine (Hcy) levels are a hallmark of hyperhomocysteinemia (HHcy), a metabolic disorder that is known to be a risk factor for cardiovascular illnesses. It greatly raises the risk of vascular problems when combined with hypertension (HTN). However, there are few statistics on the prevalence of HHcy in individuals with HTN. Objective: The present review aims to estimate the global prevalence of HHcy among adults with HTN and to highlight regional disparities, associated risk factors, and implications for clinical practice. Method: The comprehensive literature search was conducted using the PubMed and Google Scholar search engines. Studies published in …

Seizures In Camp Settings, Sandra Shapiro, Taylor Gilman, Tamar Sternfield, Jolie Skivington

CompassPoint

Managing seizures in the summer camp environment presents unique challenges, requiring not only medical attention but also empathy and understanding from both peers and caregivers. Approximately 0.5–5% of children and adolescents will experience at least one afebrile seizure by adolescence and there is a 3.6% risk of experiencing at least one seizure in an 80-year-lifespan (Murphy et al., 1995 as cited in Wilfong, 2025). Recognizing how to support a child with seizures during the camp season is essential to promoting their safety and well-being while also ensuring they have a positive and inclusive camp experience.

The Fascia Iliaca Regional Nerve Block Using Ultrasound And Landmark Technique: An Objective Structured Clinical Examination For Nurse Anesthetists, Braxton T. Beech, Parker F. Rigby

Doctoral Projects

The fascia iliaca block (FIB) is an effective regional anesthesia technique used in various clinical settings, including operating rooms, emergency departments, and pain management clinics. Despite its advantages in reducing postoperative complications and minimizing opioid use, FIB remains underutilized among Certified Registered Nurse Anesthetists (CRNAs), primarily due to limited exposure and training. This doctoral project examines the implementation of an Objective Structured Clinical Examination (OSCE) as an educational intervention to enhance CRNA proficiency in performing FIB using both ultrasound-guided and landmark techniques.

A pre- and post-test study design was conducted with 18 CRNA participants attending a continuing education workshop. Demographic …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …

A Retrospective Data Analysis Of Factors Contributing To Surgical Patients Not Achieving Normothermia, Joseph P. O'Rourke Jr, Megan Casselberry

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postoperative hypothermia, defined as a core temperature below 36°C, is a prevalent and underrecognized complication in surgical settings, contributing to increased patient morbidity, prolonged recovery, and higher healthcare costs. This program evaluation project aimed to identify and address factors contributing to intraoperative and postoperative hypothermia by retrospectively analyzing patient records from a local hospital’s EPIC electronic health record system. Guided by the Iowa Model of Evidence-Based Practice and the W.K. Kellogg Foundation Program Evaluation Model, the project systematically reviewed perioperative temperature management protocols and warming interventions across diverse surgical specialties. Data extraction and analysis focused on patient demographics, procedural variables, …

Do Perceived Social Support And Positive Religious Coping Moderate Any Relationship Between Post-Intensive Care Syndrome–Family Symptoms And Quality Of Life In Informal Caregivers Of Intensive Care Unit Survivors?, Carol R. Hirschkorn

Doctoral Dissertations and Projects

Family members and close friends often act as informal caregivers (CGs) for survivors of critical illness, assisting with activities of daily living, ongoing care needs, and adjustment to life after critical illness. These CGs simultaneously cope with their own mental, physical, and social sequelae, including significant changes (to roles and responsibilities) in everyday life. Qualitative researchers have examined this constellation of CG symptoms, which constitute post-intensive care syndrome–family (PICS-F), to understand the experiences, needs, and coping of CGs of intensive care unit (ICU) survivors. None have looked at the impact of religious coping and perceived social support on PICS-F and …

A Farewell Message, Misty L. Rhoads

Journal of Transformative Touch

No abstract provided.

Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray

Doctor of Nursing Practice Scholarly Projects

Background: Children with medically complex diseases require highly specialized care by a highly specialized team. Those with rare disease, including inborn errors of metabolism (IEMs), are a medically complex population and face significant challenges undergoing the health care transition from a child/family-centered model to an adult/patient-centered model of care. The project site follows patients with IEMs in the Metabolism Program, but previously did not have a coordinated process and had insufficient resources for patients/families for the health care transition.

Methods: The Plan-Do-Study-Act (PDSA) method was utilized as the model for improvement. Due to the complexity of the population and time …