Nursing Commons^™

Bridging The Gap: Investigating The Impact Of Adequate Prenatal Care On Adverse Maternal Outcomes Among Black And African American Women, Ciaera Ambroise

Honors Undergraduate Theses

The United States continues to face a maternal health crisis marked by persistent racial disparities, with Black women experiencing pregnancy-related mortality rates three times higher than those of White women. Despite national efforts to expand access to prenatal services, inequities in maternal outcomes remain, indicating that the quality of prenatal care may be as critical as its timing and frequency. The purpose of this thesis is to examine whether adequate prenatal care, compared to inadequate prenatal care, is associated with reduced adverse maternal outcomes among Black and African American women in the United States. Guided by a PICO question, this …

Examining The Effectiveness Of Icu Diaries In Reducing Post–Intensive Care Syndrome (Pics) Psychological Symptoms: A Rapid Review Of United States–Based Studies, Lananh Tran

Honors Undergraduate Theses

Background: The growing recognition of Post-Intensive Care Syndrome (PICS) has prompted investigation into interventions, such as ICU diaries, to mitigate the long-term psychological effects of PICS. Intensive care unit (ICU) diaries – journals written by clinicians and loved ones during an ICU admission – are a tool that can help patients reconstruct the events of their critical care experience. Entries in the diary may include clinical updates, explanation of treatments, and encouraging words from loved ones or staff. Previous research in European countries found ICU diaries may be effective in reducing psychological effects post ICU admission.

Research question: The aim …

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 …

Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

Attitudes Toward Dementia Among Nursing Students: A Cross-Sectional Study, Ngoc Ha Vo Thi, Thuy Nga Tran Thi, Ngoc Sen Hoang Thi

Health Professions Education

Purpose: Dementia is the loss of cognitive function, including thinking, memory, and communication, due to brain disorders. The global prevalence of dementia is increasing, affecting younger populations. Caring for individuals with dementia requires preparedness to manage behavioral and psychological symptoms. As future healthcare providers, nursing students are expected to have the necessary knowledge and attitudes to support dementia patients. To describe nursing students' attitudes toward dementia and explore related factors.

Methods: A cross-sectional study was conducted on 520 nursing students at Da Nang University of Medical Technology and Pharmacy. A structured questionnaire assessed demographic characteristics, academic information, knowledge, and attitudes …

Implementation Of The Downes Scoring Tool, Jennifer Oney

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

Respiratory Distress Syndrome (RDS) is a leading cause of morbidity and mortality in premature infants. It is managed with continuous positive airway pressure (CPAP), but CPAP can mask the signs of RDS, and delay surfactant therapy.

Purpose

This quality improvement project (QI) was to assess healthcare providers’ confidence in RDS and surfactant therapy through pre- and post- surveys and provided education on RDS and the implementation of the Simplified Downes Scoring Tool to assess respiratory distress in premature infants (25-36 weeks gestation).

Methods

In a Level III NICU, healthcare providers received education on RDS and the scoring Tool, they …

Impact Of Fast Track On Emergency Department Length Of Stay, Kayce Carrick Bsn, Rn, Kelsey Richmond Rn, Stacy Duncan Rn

Nurse Residency Posters

Facilitator: Melissa Harper, BSN, RN

OhioHealth O'Bleness Hospital

Impact Of Exercise And Cognitive Behavioral Therapy On Anxiety And Depression, Ranjita Subedi, Rachel Affeldt, Abigail Bentley, Gavin Gump, Madison Mitchell, Taylor Rodgers, Bayley Mullins, Libbie Woodland, Sophia Rubenkoenig

Nurse Residency Posters

OhioHealth Grant Medical Center

Hands-Free Tech For Fall Prevention, Sierra Dixon Rn, Jessica Gillam Rn, Bryan Hatheway Rn, Taightam Hicks Bsn, Rn, Kelsey Tignor Bsn, Rn, Hailie Tomsik Rn, Jeremiah Waworoendeng Rn

Nurse Residency Posters

Facilitator: Kasey Gillen, MHA, BSN, RN, NPD-BC

OhioHealth Mansfield Hospital

Impact Of Intentional Leadership Styles On Staff Nurse Satisfaction And Retention, Monica Patrick Rn, Camie Mitchell Rn, Amelia Kennedy Rn, Rachel Geiger Rn, Zachary Foster Rn, Katherine Leahy Rn

Nurse Residency Posters

Facilitator: Tess Wagner, BSN, RN

OhioHealth Riverside Methodist Hospital

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

Formal And Informal Digital Health In Tanzania: Healthcare Workforce, Regulatory And Trust Implications Of E-Patients And Virtual Care And The Development Of The Trust Framework, Kahabi Isangula, Judith Keebisilo Leo, James Tumaini Kengia

School of Nursing & Midwifery, East Africa

Digital health and virtual care are increasingly reshaping how healthcare is organized, delivered, and experienced. In Tanzania, digital transformation is evident in national commitments to digital health governance, health information exchange, hospital information systems, digital referral and emergency transportation, telemedicine, and emerging diagnostic applications supported by artificial intelligence. At the same time, patients are increasingly using social media, mobile platforms, and other digital channels to seek health information, consultations, diagnoses, and medicines, creating new forms of digitally mediated care that often operate alongside formal healthcare systems. Using a narrative synthesis design informed by a practice-based perspective, this study reviewed policy …

Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

Preventing G-J Tube Dislodgement - A Device And Communication Innovation, Sarah Clark

2026

Abstract

The Problem: G/J tube dislodgement is a frequent complication in pediatric patients.

Leads to:

• Emergency department visits
• Hospital admissions
• Delays in nutrition/medication

Impact on Patients & Families:

• IV placement (traumatic)
• Radiation exposure
• Overnight hospital stays

Impact on Nurses & System:

• Increased workload (admissions, coordination)
• Occupied inpatient beds for stable patients
• Inefficient care processes

Aims/Objectives Aim: Reduce unplanned G/J tube dislodgements and related hospital utilization.

Objectives: Develop a breakaway connector prototype

Implementation and Evaluation:
Setting: Pediatric inpatient & outpatient system
Participants: Nurses (bedside, GI, IR), caregiver, innovation team
Process: Roundtable discussions → identified workflow gaps Communication/workflow audit Developed …

How To Reduce Inpatient Violence: A Theory Synthesis From Four Models, Arthur Walker

Antioch University Dissertations & Theses

Working in an inpatient setting inherently involves an increased risk of violence. This violence can affect both staff and patients alike and can lead to psychological trauma, serious bodily injury, and even death. To mitigate this risk, many models for preventing inpatient violence have been proposed for hospitals to implement. However, the evidence for the efficacy of these methods is inconsistent, and the theoretical underpinnings are varied and slim. This dissertation seeks to improve these models by re-examining the theoretical structures for common themes of four models for inpatient violence reduction and proposing additional recommendations informed by this synthesis. First, …

Professional Identity Development Among Nursing Students: The Impact Of Structured Reflective Practice, Abdelmonim El Fadely, Kamal Takhdat, Charaf-Eddine Ahraiba, Rahma Bouali, Sabah Selmaoui, Boujemaa Agorram

Health Professions Education

Purpose This study aimed to assess the impact of a structured reflective practice intervention on the development of professional identity among nursing students. Method A mixed-methods design was adopted. The intervention, based on guided reflective practice, was implemented with a voluntary sample of 58 participants. The evaluation relied on a quasi-experimental quantitative approach using the Macleod Clark Professional Identity Scale, with a comparison group and both pre-test and post-test measurements. A qualitative component was also included to explore the dimensions of the studied concept in greater depth. Results Quantitative findings showed a statistically significant difference between the post-test means (p < 0.001), indicating that the reflective practice intervention had a positive effect on the experimental group compared to the control group. The qualitative results further illuminated students’ reflections, which were organized into ten themes corresponding to the study’s conceptual framework: professional knowledge and skills, values and ethics, the nursing role, leadership, professional self-image, social image of the profession, sense of belonging, identification with role models, theory–practice integration, and career choice. These dimensions provided a comprehensive and nuanced understanding of professional identity, capturing the complexity of the concept. Conclusion These results support the integration of reflective practice as a pedagogical approach to fostering the construction and development of a positive professional identity. Professional identity, as a rich and multidimensional concept, goes beyond the process of professionalization—it represents its ultimate achievement.

Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative For Education And Follow-Up, Elizabeth Martinez, Belinda Bordeaux, Stephanie Langevin, Cristina Herrera, Mary Smith, Merissa Doyle, Barbara Stein, Kimberly Poshar, Marissa Dunlap, Allison Silva, Eric Werner

Department of Pediatrics Faculty Publications

Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.

Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered …

Implementation Of An Acute Critical Event Debriefing To Enhance The Quality Of Cardiopulmonary Arrest Resuscitation In The Cardiovascular Intensive Care Unit At A Safety-Net Hospital, Shara Baker

Doctor of Nursing Practice Final Project Abstract

Purpose

This scholarly project aimed to implement an Acute Critical Event Debriefing (ACED) program in an intensive care unit to improve resuscitation quality by increasing post–cardiopulmonary arrest debriefing completion rates and enhancing documentation of airway confirmation during resuscitation events. The project took place in a 12-bed intensive care unit at a large academic safety-net hospital in Dallas, Texas.

Background

Structured debriefing after cardiopulmonary arrest events was recommended to enhance team performance, clinical education, and resuscitation quality. However, debriefing following code events was inconsistently conducted across many intensive care units, limiting opportunities for team reflection and quality improvement.

Methodology

The Plan-Do-Study-Act …

Treatment Manual For Sequential Format. Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course)., Robin Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

This is the Treatment for Sequential Format Two Part Program for Symptom Self Management of Auditory Hallucinations (12-Session Course & Support for Booster Dose of Course).

Treatment Manual For Nonsequential Format. Two Part Program For Symptom Self-Management (12 Session Course & Support Group For Booster Dose Of Course)., Robin Kay Buccheri, Louise Nigh Trygstad, Martha D. Buffum

Nursing and Health Professions Faculty Research and Publications

This is the Treatment Manual for NonSequential Format: Two-Part Program for Symptom Self-Management of Auditory Hallucinations: 12 Session Course & Support Group for Booster Dose of Course

Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin

West Chester University Graduate Theses, Dissertations, and Final Projects

Point-of-care testing (POCT) is used to measure a variety of healthcare data rapidly at the bedside. It can be particularly useful when laboratory data is not available at the time a patient sees their healthcare provider (HCP). Patients living with diabetes frequently do not obtain laboratory data prior to their visit with their HCP. This quality improvement projected aim to assess if use of POCT to measure an Hgb A1c level in patients with diabetes affected patient satisfaction in an endocrinology clinic. Eligible participants were asked to complete an anonymous survey, with three questions asking if having their Hgb A1c …

Building Self-Perceived Confidence Through Occupational Therapy And Nursing Student Peer Teaching, Jennifer A. Tokash, Melissa Nolan, Jamie Bittiger, Jessica Wagoner, John Damiao, Michelle Lopez

Journal of Occupational Therapy Education

Peer teaching, which is student-to-student instruction, has emerged as a promising pedagogical strategy in higher education, yet it remains underexplored in health professions curricula. While traditional professor-led instruction remains the predominant model, peer teaching may offer comparable or enhanced outcomes, particularly in fostering students’ self-perceived confidence and active learning. This study examined the impact of peer teaching on nursing students’ self-perceived confidence in applying ergonomic principles and performing safe patient handling techniques, as instructed by occupational therapy students. Additionally, the study assessed occupational therapy students’ self-perceived confidence in measuring vital signs following instruction provided by nursing students. Using a quasi-experimental …

Optimising Vaginal Microbiome Profiling For Clinical Translation: A Comparative Assessment Of Sample Storage Methods And A Vagina-Specific 16s Rrna Gene Database, Alishum Ali, Jeffrey A. Keelan, Blagica Penova-Veselinovic, Morten E. Allentoft, Michael Bunce, Claus T. Christophersen

Research outputs 2022 to 2026

Vaginal microbiome composition has been linked to risk of preterm birth (PTB), a persistent global health challenge. 16S rRNA microbial profiling has identified specific vaginal community state types (CSTs) that have been associated with PTB risk. Diagnostic profiling requires standardised pre-analytical protocols. We evaluated two storage methods and validated a curated, vagina-specific 16S rRNA gene database (VagDB) to enhance annotation. Paired Copan FLOQ swabs from 22 women at high PTB risk were processed for either (a) dry/immediate freezing or (b) Amies-stabilisation/refrigeration. Amplicon sequence variants were generated via 16S rRNA gene (V4) PCR and Illumina sequencing. We assessed diversity, composition, and …

Paternal Age Is Associated With Offspring Bone Health—But Not Soft Tissue Composition Or Fracture: The Vitamin D In Pregnancy Study, Mia A. Percival, Kara B. Anderson, Julie A. Pasco, Marc Sim, Sarah M. Hosking, John D. Wark, Natalie K. Hyde

Research outputs 2022 to 2026

Summary: Emerging evidence suggests that paternal health may be associated with offspring later life heath. In this study, advanced paternal age at childbirth was associated with poorer offspring bone mineral density and content at age 11 years. These findings suggest that paternal age may impact childhood musculoskeletal development, warranting further investigation. Introduction: Maternal health during pregnancy is known to impact offspring’s later life health. However, emerging evidence suggests that paternal factors may also be important. Advanced paternal age is associated with poorer offspring outcomes, yet few studies assess musculoskeletal outcomes. This study investigated the association between paternal age at childbirth …

The Effectiveness Of Virtual Reality Aggression And Violence De-Escalation Training For Nursing And Midwifery Students: A Quasi-Experimental Study, Joshua Johnson, Brennen Mills, Luke Hopper, Sara Hansen, Kelley Mumford, Renju Joseph, Susan Philip, Gina Kruger, Abdi D. Osman

Research outputs 2022 to 2026

Background: Nursing students experience substantial exposure to aggression and violence while attending clinical placement. De-escalation training can effectively prepare students for aggressive encounters, yet is resource-intensive to deliver. Immersive virtual reality (VR) may improve training accessibility for nursing students. Aim: To evaluate the effectiveness of a VR de-escalation training program to improve nursing students’ confidence in managing patient aggression and its perceived usability. Methods: This study utilized a single-group quasi-experimental pre-/post-test design. Undergraduate Australian nursing students (n = 221) completed a VR de-escalation training program, providing pre-/postintervention self-reported confidence in coping with patient aggression, system usability, and motion sickness data. …

Methodological Approaches To Assessing Clinical Reasoning In Simulation-Based Education: An Integrative Review, Dhanya Anand Anil Kumar, Natasya Raja Azlan, Hugh Davies, Debbie L. Massey, Karen Strickland

Research outputs 2022 to 2026

Aims: Clinical reasoning is a critical skill for nurses, developing progressively through structured education and clinical experience. Simulation-based learning provides nursing students with a safe, immersive environment to develop this skill if it is thoughtfully designed and rigorously implemented. This review addresses a key gap in nursing education research by exploring methodological trends and key elements to consider for developing simulations to assess clinical reasoning in nursing students. Design: An integrative review using Whittemore and Knafl's framework. Data sources: Six databases (CINAHL, PubMed, ScienceDirect, MEDLINE, PsycInfo and Google Scholar) were searched for studies published from 2014 to September 2025. Review …

Experiences Of First-Year Nursing Students Using Community Volunteers As Simulated Participants For Teaching Safe Medication Administration: A Cross-Sectional Survey, Hugh Davies, Lea Aboo, Kristi Nicholls, Martina Costello, Carol Crevacore

Research outputs 2022 to 2026

Aims: To explore responses of first-year nursing students to simulated participant methodology and the level of difficulty playing the role of patient experienced by community volunteers. Background: Absence of therapeutic relationships between nurse and patient threatens medication safety. Simulation-based learning provides a safe environment for students to practice medication administration. Design: Cross-sectional survey incorporating Mezirow’s transformative learning theory. Methods: First-year Bachelor of Science Nursing students participated in a simulated medication administration scenario supported by volunteers playing the role of patients. A Likert and open-ended post-simulation questionnaire measured students’ perceptions of realism in the performance of simulated participant volunteers. Simulated participant …

Gender Justice In The Triple Planetary Crisis: A Scoping Review, Catelyn Richards, Micah Peters, Julia Charalambous, Lila Singh-Peterson, Lucy Osborn, Aletha Ward, Jessica Leclair, Tracy Levett-Jones

Research outputs 2022 to 2026

Aim: To identify and report how gender justice is conceptualised and discussed in contemporary health literature in relation to the Triple Planetary Crisis of climate change, pollution and biodiversity loss, with a particular focus on the experiences of women and gender-diverse populations, and the representation of nurses and other healthcare professionals dominated by women. Design: Scoping review. Data Sources: Searches were conducted across MEDLINE (Ovid), Scopus, CINHAL, Embase and ProQuest, focusing on studies published from January 1 2000–23 September 2024. Review Methods: The review was conducted in accordance with the JBI methodology for scoping reviews and reported against the Preferred …