Uncovering The Path To Diagnosis Among Adults With Attention-Deficit/Hyperactivity Disorder: A Constructivist Grounded Theory Mini-Study, Jeffrey D. Whitaker, Rick Zoucha, Melissa Kalarchian

Graduate Student Research Symposium

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical …

Evaluating The Impact Of Evidence-Based Education On The Utilization Of Preoperative Gastric Ultrasound For Patients On Glp-1 Agonists, Rachel K. Gibbons, Wesley Johnson, Rachel Cartillar

Create@State

Abstract

Patients taking glucagon-like peptide-1 (GLP-1) receptor agonists have a 30.5% higher prevalence of retained gastric contents at the time of surgery despite being held according to ASA and AANA recommendations, highlighting the need for enhanced preoperative assessment to reduce aspiration risk (Sen et al., 2024; Willson et al., 2024). Although an effective, noninvasive tool for assessing gastric contents and reducing the risk of pulmonary aspiration, gastric ultrasound remains underutilized in anesthesia practice (Pan et al., 2024). This evidence-based project evaluated whether an educational intervention could improve anesthesia providers’ knowledge, attitudes, and readiness to adopt point-of-care gastric ultrasound (POC-GUS) into …

Implementing A School Nurse-Facilitated Communication And Tracking Bundle To Improve Vision Care Follow-Up Rates, Natalie Autumn Johnston

ONU Student Research Colloquium

Abstract

Problem: Children’s cognitive, physical, and social development are influenced by vision. This means that early interventions in school-aged children are critical. While school-based vision screenings are standardized and effective in identifying visual deficits, post-screening follow-up rates with eyecare professionals remain low. This trend is especially prevalent in underserved school districts, perpetuating systemic healthcare gaps.

Purpose: The purpose of this study is to evaluate whether the rates of follow-up eye care among school-aged students who fail vision screening will improve following the implementation of school nurse facilitated follow-up communication and referral tracking bundle.

Methods: This study will …

Gamification As A Strategy For Interprofessional Learning, Chisom S. Enebechi, Aislinn M. Dorko

Research & Creative Achievement Day

Background: A Community-based, student-led clinic provides free health services to underserved areas, bringing together students from allied health disciplines to promote interprofessional collaboration and health promotion. Previous orientation sessions were lecture-based with a team-building activity providing limited opportunities for active learning. To address this, a gamified orientation activity was developed using realistic, scenario-based cases designed to exemplify common community health situations. Purpose: This quality improvement project aims to evaluate whether gamification improves students' perceived ability to communicate, collaborate, and understand roles and responsibilities when delivering team-based care. Methods: The project was guided by Bandura's Social Learning Theory and implemented using …

Care, Capitalism, And Croissants: Interprofessional Students Take On Business Of Healthcare In Paris, Beth A. Komay, Phoebe S. Enebechi, Selma Dzamalija, Nicole A. Sharp

Research & Creative Achievement Day

The Business of Healthcare in Paris is a faculty-led study-away program that unites business, nursing, and other healthcare students in an immersive experience of global healthcare systems. The primary design of this course is around interprofessional learning that integrates coursework and cultural experiences from within the Midwest United States (US) and France. Students begin the course by visiting healthcare facilities and small alternative-therapy businesses in the US, gaining initial exposure to diverse care environments. They then travel to Paris and surrounding areas to explore comparable sites, including hospitals, an art therapy center, a residential rehabilitation facility, and small businesses providing …

Public Health Book Club, Ashia Meister, James W. Durst, Ameila Beyer, Kelly K. Freymiller, Julia I. Kunz, Jaci M. Winchell, Josephine M. Sandquist, Chloe F. Sand

Research & Creative Achievement Day

Introduction: This project describes the development and implementation of a book club focused on population health topics to promote learning, discussion, and community engagement. A public library is a safe space to host book club meetings due to its non-intimidating environment. All members of the community are welcome to participate. A book club was hosted on campus for members of the nursing cohort to attend. With a focus on public health, these book clubs build awareness, critical thinking, and community engagement around population health issues. Purpose: The promotion of a book club can improve health literacy in the community by …

A Collaborative Approach To Strengthening Behavioral Strategies To The Arcadia School District, Mallory Arndt, Sada Stanley, Ariana Huntington, Erin Janiszewski, Syndey Graf, Josie Becker, Bailey Ripley, Dana Jones, Gabby Rinowski, Luke Garner, Hailey Schliep

Research & Creative Achievement Day

The School District of Arcadia is lacking mental health resources due to budget cuts from state and federal levels. Mental health needs have become a rising concern in recent years. With that, the guidance counselors, who traditionally supported students' emotional regulation and behavioral needs, became increasingly occupied with Academic and Career Planning requirements, leaving them with limited time to address students' mental health needs. To help address this need, Winona State University nursing students partnered with the district's guidance counselors to develop supplemental emotional management and decision-making skills-building videos that counselors could use during busy periods to support students' coping …

Treating Depression With L-Methylfolate: A Review Of Evidence, Marianna G. Pettit

Epsilon Sigma at-Large Research Conference

Abstract

Introduction & Background: Depressive disorders have many different causes. Folate deficiency can sometimes be behind these disorders, due to this vitamin’s role in neurotransmitter synthesis. Some research suggests that supplementing with an active form of folate improves depressive symptoms with and without antidepressant use. Purpose Statement Question: For individuals with depressive disorders, does supplementation with L-methylfolate (LMF) reduce symptoms of depressive disorders with or without use of an antidepressant? Literature Review: A manual literature search for sources published within the past 7 years revealed 557 documents from four different databases. Key search words included, “depression,” “treatment,” …

A Historical Analysis Of The Development Of Prenatal Care In The U. S., Kristen Montgomery Phd, Cnm, Aprn, Shelby Greene Bsn, Rn, Lauren Griffin Bsn, Rn, Destiny Lewis Bsn, Rn, Lauryn Lewis Bsn, Rn, Bryleigh Newberry Bsn, Rn, Brittany Scott Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: This paper examines the historical development of prenatal care in the United States, tracing its evolution from informal, home—based management to structured, evidence-based systems that are central to maternal and fetal health.

Aims: The specific aim of this project was to determine how prenatal care evolved in the United States.

Methods: A historical methods approach was used. Historical documents were reviewed using PubMed, CINAHL, and Google Scholar to find relevant resources. Relevant articles were reviewed by the research team and analyzed for components regarding the development of prenatal care. All members of the research team reviewed the articles and …

Nurse-To-Patient Ratios In Adult Medical-Surgical Units, Kayleigh A. Runion, Emily G. Barnette, Maddison K. Wood, Jeremy Walker

Epsilon Sigma at-Large Research Conference

Nurse-to-patient ratios in adult medical-surgical floors vary across healthcare settings and have been linked to patient safety and quality outcomes. Nurse-to-patient ratios of 1 to 6 or greater are most common in practice settings, despite the growing evidence that higher nurse workloads are associated with increased mortality, longer length of stay, higher readmission rates, mistakes, and miscommunication in nursing care. The purpose of this evidence-based practice project is to examine whether applying safer nurse-to-patient ratios, 1 to 4 instead of 1 to 6 or higher, improves patient safety outcomes. Using the Johns Hopkins Evidenced-Based Practice Model, a project was put …

Does Time Matter? Comparing 8- And 12-Hour Registered Nurse Shifts., Ava P. King, Abby L. Goodall, Cheryl L. Goodall, Makayla B. Ramsey, Imari K. Golden

Epsilon Sigma at-Large Research Conference

This project analyzes the effect that registered nurse's shift length has on patient outcomes and quality of care. The research specifically explores a well-debated healthcare issue; are 12-hour shifts associated with poor patient care due to fatigue? By comparing errors made in 12-hour and 8-hour shift lengths of registered nurses, it can be determined if a trend can be seen in declining patient care. Not only will this research shed light on nurses' fatigue and burnout, but it will also showcase the patient dangers associated with overworking. Overall, the goal is to bring awareness using statistical data that explains why …

Historical Development Of Vaccines And The Public's Response, Kristen Montgomery, Samantha Prince Bsn, Rn, Melissa Ealey Bsn, Rn, Jarrad Morelock Bsn, Rn, Shelby Johnson Bsn, Rn, Kokeshia Crosby Bsn, Rn, Stephanies Himes Bsn, Rn, Theresia Hinton Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Vaccines, which have become one of the most important medical accomplishments in the prevention of communicable diseases, have a history that dates to the use of variolation as early as the 11th century. The purpose of this study is to explore the historical development of vaccines and to determine the characteristics that emerged when new vaccines were developed.

Aims: The specific aim of this study is to understand if all vaccines have been received about the same by the general public or if there are certain different or diverse characteristics associated with the introduction of different vaccines.

Methods: A …

A Systematic Literature Review On Alternative Treatment Modalities In Adults With Treatment Resistant Depression, Brian Miller

Epsilon Sigma at-Large Research Conference

Abstract

            Currently, Psychiatric Mental Health Nurse Practitioners (PMHNPs) often defer to electroconvulsive therapy (ECT) for individuals with TRD who fail to achieve resolution of their disorder. However, many individuals do not meet criteria for ECT or decline the treatment due to side effects and associated risks. To synthesize potential alternative treatments and address the current gap in literature that does not include first-line preferred electroconvulsive therapy (ECT), a systematic literature review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA 2020). Databases searched for this review included the Cumulative Index to Nursing and Allied Health Literature …

The Impact Of Social Interaction On Patient Well-Being With Transition Into Long-Term Care Settings: A Review Of Interventions For Improved Patient Outcomes, Helen Whitney Harmon

Epsilon Sigma at-Large Research Conference

Abstract

Purpose: When individual patients are transitioned from home or acute care settings to more long-term care environments such as skilled nursing units or assisted living facilities, the residents are at an increased risk of experiencing loneliness, which is linked to depression, anxiety, and increasing cognitive decline, and other detrimental outcomes.

Aims: Combinations of peer-reviewed qualitative and quantitative research studies were analyzed to determine what factors contributed to changes in patient well-being, mental health and overall quality of life during these transitions.

Methods: One article focusing on preventable healthcare transitions in patient population was able to link higher medical acuity …

Does Mandated Paid Maternity Leave Affect Postpartum Depression?, Amaya S. Hall, Shay Y. Bullwinkel, Loran M. Hurley, Sara Cook

Epsilon Sigma at-Large Research Conference

This project analyzes the effects that paid maternity leave has on postpartum depression. Upon reviewing multiple studies, it has been demonstrated that unpaid maternity leave is associated with postpartum depression. Throughout researching postpartum depression rates, it has been proven to be much higher in unpaid leave compared to paid maternity leave. Mothers that have the burden of staying home with their infants and having to juggle time off work, without being compensated, are at an increased risk of experiencing postpartum depression. It has been shown that when a mother is able to focus on her child and her healing after …

The Role Of Nurses In Robotic-Assisted Surgery, Tehya Wiedemeier, Gretchen Faith Grambow, Ella Froehlich, Whitney Anna Holmes

Epsilon Sigma at-Large Research Conference

The research examines the evolving role of nurses in robotic-assisted surgery. As the technology advances, the nursing role is expanding beyond the traditional responsibilities. The method of literature review for this study was completed through deductive content analysis based off three data bases called Science Direct, PubMed (Medline), and Scopus. Current research is working towards trying to bring educational awareness to the role of nurses within the robotic surgery environment and what new skills they will have to acquire.  For nurses to successfully fit into the role of assisting within robotic surgery, they will need to obtain a higher level …

Mindfulness-Based Therapy For The Treatment Of Anxiety In Adolescents, Alicia Lemaster

Epsilon Sigma at-Large Research Conference

Abstract

Adolescent anxiety disorders represent a significant and growing public health concern, with increasing prevalence and associated functional impairment. Traditional treatments, including cognitive behavioral therapy (CBT) and pharmacologic interventions, are effective but often limited by barriers such as access, stigma, and adherence. Mindfulness-based interventions (MBIs) have emerged as a promising alternative or adjunctive approach to address anxiety symptoms in adolescents. The purpose of this literature review is to evaluate the effectiveness of structured mindfulness-based therapy programs in reducing anxiety symptoms among adolescents compared to usual care. A systematic literature search was conducted using databases including PubMed, CINAHL, and PsycINFO, focusing …

Improving Glp-1 Ra Initiation In Primary Care Through A Paper-Based Clinical Decision Support Tool, Carissa R. Bowery, Karen Carver

Epsilon Sigma at-Large Research Conference

Title: Improving GLP-1 RA Initiation in Primary Care Through a Paper-Based Clinical Decision Support Tool

Authors: Carissa R. Bowery, MSN, FNP-C; East Tennessee State University College of Nursing. Karen M. Carver, PhD, APRN, FNP-C; East Tennessee State University College of Nursing

This quality improvement project focuses on improving evidence-based pharmacologic management of adults with type 2 diabetes mellitus (T2DM) and obesity through implementation of a paper-based clinical decision support (CDS) tool in primary care. The aim is to increase initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among eligible patients and improve provider adherence to current clinical guidelines.

Processes: This …

A Systematic Literature Review Examining Suicide Risk Factors In Older Adults, Carolyn Bivens

Epsilon Sigma at-Large Research Conference

Introduction & Background: Suicide in older adults is a increasingly prevalent tragedy worldwide, and rates in North America have uniquely increased over the past two decades. The context of the cultural environment of North America and population-specific factors in the elderly must be explored to protect this vulnerable group.

Purpose Statement Question: In older adults living in North America, what experiences and risk factors influence the development and severity of suicidal thoughts and behaviors?

Literature Review: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart guided the search of the Cumulative Index to Nursing and Allied Health Literature …

Postpartum Psychosis Risk In Women With Bipolar Disorder, Rachel R. Lay

Epsilon Sigma at-Large Research Conference

Psychiatric relapse and postpartum psychosis pose vital psychological threats to women with bipolar disorder. The phase after delivery implies a great number of biological, psychological, and social alterations that might predispose to mood fluctuations and extreme psycho-psychiatric behavior. A systematic literature review assessed the recent literature on postpartum relapse risk, contributors, and maternal outcomes in women with bipolar disorder. Systematic search of three electronic databases, CINAHL, PubMed, and PsycINFO, revealed 168 studies dating back to 2022. Title and abstract screening of 124 articles was carried out after elimination of duplicates and other eligibility criteria. Eighteen articles were full-text reviewed, and …

Adolescent Depression, Telepsychiatry, And Access, Dustin Strickland

Epsilon Sigma at-Large Research Conference

Adolescent depression is prevalent, undertreated, and associated with long-term morbidity if left untreated. Several structural barriers impede timely access to specialty mental health care in this age group. Telepsychiatry, including therapist delivered videoconference psychotherapy and internet delivered cognitive behavioral therapies (ICBT) have been developed to expand access and continuity of care for adolescents. This modality, however, has not been thoroughly evaluated to determine the effectiveness of telepsychiatry in improving access to services and its ability to reduce depressive symptoms in adolescence. A structured literature review identified six primary studies and four complementary systematic reviews evaluating this topic. Randomized trials show …

Building The Nursing Leadership Pipeline: Outcomes Of A Statewide Emerging Nurse Leader Fellowhip, Kathleen Kinser Dnp, Aprn, Belinda J. Fleming Phd, Christie Manasco Phd, Monaco M. Briggs Edd, Yan Cao Phd, Jennifer Hitt Phd

Epsilon Sigma at-Large Research Conference

Healthcare systems increasingly require skilled nurse leaders to address workforce shortages, quality improvement demands, and complex care environments. However, many nurses transition into leadership roles without formal preparation. In this quality improvement project, nurse scientists Kathleen Kinser DNP; Belinda Fleming, PhD; and Christie Manasco, PhD, from the Tennessee Center for Nursing Advancement (TCNA) evaluated outcomes of the Emerging Nurse Leader Fellowship developed to strengthen foundational leadership competencies among novice nurse leaders. Guided by transformational leadership theory, the fellowship was a statewide, cohort-based, instructor-led, asynchronous online program emphasizing practical leadership development and application in clinical settings. Two cohorts participated and completed …

Association Of Self-Efficacy, Preceptor Teaching, And Role Modeling With Practice Preparedness In Student Nurse Practitioners, Quinton Carroll, Pi-Ming Yeh, Jean Croce Hemphill, Melessia Webb, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

Purpose: Final-semester student nurse practitioners (SNPs) often report unpreparedness for practice. Little is known about which preceptor characteristics prepare students for practice. The purpose of this study was to examine whether final-semester SNPs' practice preparedness is associated with their self-efficacy and most significant preceptor’s clinical teaching effectiveness and role modeling.

Aim: To identify which student and preceptor factors are associated with and predict SNP preparedness.

Methods: Cross-sectional correlational study of final-semester SNPs (N = 83). Participants completed the New Nurse Practitioners’ Practice Preparedness Survey, New General Self-Efficacy Scale, Cleveland Clinic Teaching Effectiveness Instrument, and Role Model Apperception Tool. Analysis …

Implementing The Abcdef Bundle In A Rural Critical Care, Kayla Hubbard

Epsilon Sigma at-Large Research Conference

Patients admitted to the critical care unit are at risk of debilitating adverse outcomes including Delirium, Post intensive care syndrome (PICS), debility, wounds, depression, and both mental and physical impairments. Complications related to ICU care can easily be combatted by using a multidisciplinary approach. The ABCDEF bundle serves to incorporate all aspects of a critically ill patients care in a simple, easy to follow bundle focusing on assessment of pain (A), both spontaneous awakening ang breathing trials (B), choice of sedation/analgesic (C), delirium (D), early mobility (E), and family involvement (F). A quality improvement project was designed and piloted in …

A Historical Study Of The Nursing Role, Kristen Montgomery, Jessica Aranda Bsn, Rn, Amanda Dalton Bsn, Rn, Machea Scott Bsn, Rn, Lisa Desantis Bsn, Rn, Halle Hilton Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Historically, nurses have been at the bedside simply following the direction of physicians, but much has changed since then.

Aims: The purpose of this study is to examine how the roles of nurses have changed over the decades, from pre-professional caregiving to advanced practice. This study focuses on the birth of nursing as a profession, the direct experiences of nurses from different generations, the shift in physician-directed care to collaborative care, how nurses interpret the impact of major healthcare transformations on their role, and the emergence and development of the nurse practitioner role.

Methods: The study was conducted using …

Using Path Analysis To Examine The Psychological Well-Being Model For U.S. College Students, Pi-Ming Yeh, Cheng-Huei Chiao, Gavin Waters

Epsilon Sigma at-Large Research Conference

Background: College students’ psychological well-being and mental health issues are very important in this society. Little is known about a comprehensive psychological well-being model for college students.

Purpose: The purpose of this study was using Path Analysis to examine the Development of Personality and Psychological Well-Being Model among US college students.

Methods: This was a cross sectional, descriptive design. The 481 participants were recruited from nursing and business college students in the United States. After IRB approval, the trained researchers explained this study to college students. After agreeing to participate, they signed an informed consent form. Upon completion of a …

A Historical Analysis Of The Development Of Childbirth In The U. S., Kristen Montgomery, Kayleigh Berg Bsn, Rn, Emily Greer Bsn, Rn, Marsha Hedgecough Bsn, Rn, Emma Holden Bsn, Rn, Halle Ingle Bsn, Rn, Alexis Tolbert Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: The purpose of this project is understand the historical development of childbirth from early documentation of birth in the home to modern day obstetrics, where most deliveries occur in the hospital. Approximately 3.5 to 4 million births occur each year in the U. S.

Aims: The aim of this study is to understand the historical development of childbirth in the U.S. with a particular emphasis on maternal autonomy. Depending on the amount of materials available, the research may be limited to the Appalachian Region.

Methods: Using a historical method, materials were located that traced the trajectory of childbirth from …

The Impact Of Customized Alarm Sounds On Reducing Alarm Fatigue In Icu Nurses, Abigail L. Kendrick, Elizabeth G. Dunkum, Carly F. Harris

Student Scholar Showcase

Within hospital care, particularly in intensive care units, alarm fatigue poses a major threat to patient safety. As a result of the constant sound of alarms, nurses become desensitized and overstimulated in the health care setting. Patient safety is threatened by an increased risk of errors in care, which may lead to complications and poor health outcomes. By systematically reviewing various research studies within the time span of 2020-2025 regarding interventions to decrease the relevance of alarm fatigue, research suggests that there are methods that can be applied via numerous approaches. By customizing alarm sounds by severity, it is believed …

Nitrous Oxide Use In Labor, Aimee Aberson, Janae Cam, Rylie Franken, Rachel Henriksen, Ben Robinson, Pam Hulstein

Celebration of Research

Effective pain management during labor is a critical part of maternal care. It influences the mother’s physical and emotional experiences of childbirth. Epidural anesthesia and intravenous opioids are commonly used as analgesia in laboring mothers, but nitrous oxide (N₂O) has proven to be a safe, noninvasive alternative. It allows mothers to maintain mobility and consciousness while still reducing some pain perception. The purpose of this evidence-based practice project is to evaluate the effectiveness, safety, and satisfaction associated with N₂O use during active maternal labor. It reviews current literature on N₂O use during labor, focusing on maternal and neonatal safety, effectiveness …

Role Of Dental Screening In Preventing Hip Prosthetic Joint Infections, Aidan Anderson, Cailee Dix, Emma Franken, Erin Keizer, Zavyr Metzger, Tyra Snyder, Pam Hulstein

Celebration of Research

Hip arthroplasty is a common procedure, but Periprosthetic joint infection (PJI) remains a serious postoperative complication associated with increased hospital stays, readmissions, and costs. Evidence suggests that poor oral health may contribute to PJIs through the spread of bacteria from the mouth to the surgical site. This project examined the relationship between preoperative dental health and postoperative outcomes in adults aged 50–90 undergoing hip replacement. A literature review using the Johns Hopkins Research Evidence Appraisal Tool evaluated 19 studies from databases such as PubMed and ScienceDirect. While no clear association was found between specific dental risk factors and PJIs, untreated …