Nursing Commons^™

The Effect Of Exercise On The Development Of Gestational Diabetes Mellitus In Pregnancy: A Systematic Review Of Literature, Abigail Reiche

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review is to synthesize literature examining the relationship between using exercise as a preventative method for gestational diabetes development during pregnancy, and the effect it may have on lowering glycemic levels. Health Source: CINAHL and PubMed were systematically searched for peer-reviewed journal articles that studied pregnant women (P), and the relationship of consistent exercise (I), compared to no physical exercise (C), on lowering glycemic levels resulting in positive pregnancy outcomes (O), throughout gestation (T). Twenty articles were retrieved in accordance with the PICOT objectives. Additional criteria included only articles from 2019-2024 and articles that were …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Student Research Posters

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

Prevention Of Burnout Among Critical Care Nurses, Jenelle Balaoing, Junela Bautista

Nursing | Student Research Posters

Background: Nursing burnout is a state of mental and physical exhaustion caused by excessive stress among nurses. Critical care nurses face challenges with direct patient care that contribute to emotional and psychological strain that are greatly influenced by workplace adversity and emotional management. Purpose: This research examines the prevalence of burnout among pediatric and adult intensive care unit (ICU) nurses, highlighting particularly high rates of burnout among those with extended years of service. Method: ICU nurses will participate in a qualitative interview that involves open ended questions relevant among burnout and resilience during shifts. Aspects specifically years of critical experience …

Improving Pharmacovigilance Via Systematic Gass Screening And Interdisciplinary Collaboration In The Outpatient Setting, Dustin Bower

Doctor of Nursing Practice Projects

The goal of this Doctor of Nursing Practice (DNP) quality improvement project was to enhance pharmacovigilance practices among non-medical mental health providers (NMMHPs) in an outpatient psychiatric setting. The project addressed the issue of limited recognition and reporting of adverse drug reactions (ADRs) by NMMHPs, which can lead to delays in clinical intervention and compromise patient safety. To tackle this problem, a quasi-experimental, pre–post intervention design was employed. Two evidence-based strategies were implemented: (a) eight weekly collaborative training sessions that focused on identifying, documenting, and communicating ADRs, and (b) the integration of the Glasgow Antipsychotic Side-Effect Scale (GASS) into the …

Enhancing Provider Knowledge And Compliance With Diabetic Retinopathy Screening Through Education: A 4-Week Plan, Maureen Odemena

Doctor of Nursing Practice Projects

Diabetic retinopathy (DR) is a leading cause of vision impairment that can be prevented if found and treated early. Inadequate provider knowledge and adherence to guidelines, and low referral rates for screening at the project site, highlighted the need for targeted training. Studies show that evidence-based education plans improve engagement in DR screening. This quality improvement (QI) project aimed to impact knowledge, self-efficacy, and compliance among healthcare providers (HCPs—nurse practitioners and physicians) and increase screening rates by implementing an American Diabetes Association (ADA) guideline-based education plan over 4 weeks. Based on the health belief model and Kurt Lewin’s change theory, …

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 …

Editorial – Dec 2025, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Effect Of Focussing On Anastatica Hierochuntica Flower On Labour Pain, Duration Of Labour And Perceived Fatigue During Labour: Randomized Controlled Study, Emine Koç, Şükran Başgöl, Sümeyye Bal, Sabire Kirtiloğlu

Journal of Asian Midwives (JAM)

Background: Maternal fatigue and pain during labour can adversely affect the health of the mother, fetus, and newborn. Anastatica hierochuntica is a plant traditionally used in some cultures during childbirth rituals. When placed in water, the dried flower gradually unfolds and symbolically represents the opening of the uterus and birth canal. This study aimed to investigate the effect of focusing on the Anastatica hierochuntica flower during labour on labour pain, duration, and perceived fatigue.
Methods: This randomized controlled trial was conducted in the delivery unit of a mother-friendly hospital with 119 participants 60 in control group and 59 in intervention …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …

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 …

Gender Differences In Psychological Strengths Among Rural Adolescents, Angela Preston, Jodi Bullard, Rachel Smith, Ashlyn Peppler

Nursing Faculty Publications and Presentations

Purpose: Rural adolescents often lack access to mental health care along with increased rates of depression and suicide completion. While psychological strengths have been associated with positive outcomes globally, little is known regarding the prevalence of these indicators (hope, self‐efficacy, resilience, optimism, and gratitude) among adolescents living in rural Texas. The purpose of this study was to describe how rural adolescents report their psychological strengths and examine the data for potential gender differences.

Design and Methods: A secondary analysis of cross‐sectional data was performed on the RStudio platform using tests of central tendency and inferential statistics. Results: There were 425 …

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 …

Glp-1 Medications For Kids: Do They Work, And At What Price?, Sylvia Peña, Marilyn Frenn

College of Nursing Faculty Research and Publications

Context

Childhood obesity continues to increase along with the numbers of children with severe obesity and related comorbidities. This meta-analysis1 sought to determine whether or not glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications are safe and effective for children and adolescents.

Methods

Appropriate search and abstraction approaches were used in the meta-analysis of randomised controlled trials making it the highest level of evidence. Included studies were those with participants younger than 18 years with obesity, overweight, pre-diabetes or type 2 diabetes (T2D) assessing GLP-1 RAs alone or with lifestyle modification versus placebo published between 2023 and 2025. Most participants …

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 …

Augmenting Large Language Models To Predict Social Determinants Of Mental Health In Opioid Use Disorder Using Patient Clinical Notes, Madhavi Pagare, Deva Sai Kumar Bheesetti, Inyene E. Essien-Aleksi, Mohammad Arif Ul Alam

Health Sciences Faculty Publications

Objective

Identifying social determinants of mental health (SDOMH) in patients with opioid use disorder (OUD) is crucial for estimating risk and enabling early intervention. Extracting such data from unstructured clinical notes is challenging due to annotation complexity and requires advanced natural language processing (NLP) techniques. We propose the Human-in-the-Loop Large Language Model Interaction for Annotation (HLLIA) framework, combined with a Multilevel Hierarchical Clinical-Longformer Embedding (MHCLE) algorithm, to annotate and predict SDOMH variables. Materials and Methods

We utilized 2636 annotated discharge summaries from the Medical Information Mart for Intensive Care (MIMIC-IV) dataset. High-quality annotations were ensured via a human-in-the-loop approach, refined …

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 …