Nursing Commons^™

Evaluating The Impact Of Glp-1 Receptor Agonists On Perioperative Aspiration Risk: The Role Of Preoperative Fasting Duration, Caitlin Maureen Carter Bsn, Rn, Adam Wade Johnson Bsn, Rn, Allison Whitney Jones Bsn, Rn, Joseph Kaesberg Bsn, Rn, Kelly Maura Watson Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for diabetes and obesity due to their metabolic benefits; however, these medications delay gastric emptying, raising concern for increased residual content (RGC) and aspiration risk during anesthesia. Current perioperative fasting and medication management guidelines for patients taking GLP-1 RAs remain inconsistent, creating uncertainty for anesthesia providers. This scoping review aimed to synthesize current evidence on the relationship between GLP-1 RA use and perioperative gastric safety, with particular focus on fasting duration and aspiration risk.

Methods

A scoping review was conducted in accordance with PRISMA-ScR guidelines. Searches were performed using the …

Enhancing The Diversity And Number Of Certified Registered Nurse Anesthetists: A Proposed Pipeline Program For Underrepresented Students, Alexis Lamoreaux

Doctor of Nursing Practice Scholarly Projects

The underrepresentation of minority groups in the Certified Registered Nurse Anesthetist (CRNA) profession impacts healthcare providers’ diversity and cultural competence. This Final Scholarly Project (FSP) proposes a pipeline program to increase diversity within the CRNA field by providing academic support, mentorship, and clinical exposure to students from underrepresented backgrounds. Given the shortage of anesthesia providers, especially in underserved areas, improving access to the CRNA profession for minority students is critical for enhancing patient outcomes. This FSP suggests establishing mentorship and skill development concepts through a 12-month structured program that targets minorities, first-generation college students, or those from rural backgrounds. The …

Empowering Voices: A Qualitative Exploration Of Shared Governance Among Healthcare Workers In Clinical Practice, Ayman Alhazaymeh

Doctoral Projects

This project intervention evaluated the implementation of shared governance (SG), focused on partnership council activities and staff perception. The shared governance framework has several pillars, such as Partnership, Equity, Ownership, Accountability, and Shared Decision-Making, to support the design of healthcare organizations for excellent patient care (Porter-O’Grady, 2009). To effectively evaluate the SG implementation and ensure the ongoing success of the SG process, the author investigated staff contributions and actively sought feedback. He provided templates and guidelines for the partnership council and collected staff feedback. Murray et al. (2016) stated that the partnership council reported empowering staff to implement innovative solutions …

Evaluating The Impact Of A Meaningful Recognition Bundle On The Health Of The Emergency Department Work Environment And Emergency Nurse Burnout, Sean Truesdell

Doctoral Projects

Background: The health of the work environment significantly influences emergency nurse practice. The Emergency Nurses Association and the American Association of Critical-Care Nurses have called for the establishment of a healthy work environment (HWE) to improve outcomes, reduce burnout and turnover, and increase job satisfaction. Meaningful recognition is consistently among the lowest-performing HWE standards. Purpose: To implement a bundle of meaningful recognition elements in the Emergency Department (ED) and evaluate the outcomes. Methods: A quality improvement project was conducted in the ED of a non-profit community health system in Northern California. The Healthy Work Environment Assessment Tool (HWEAT) and Oldenburg …

Advancing Equitable Nurse Assignments Through Nursing Workload Score Categorization In An Adaptable Acuity Unit At An Academic Health Center, Moses Albaniel

Doctoral Projects

Inpatient nursing shift assignments often rely on clinical judgment, which can lead to inequitable workload distribution on mixed‑acuity units. This quality improvement project evaluated assignment equity using the coefficient of variation (CV) of nursing workload acuity scores and examined the relationship between workload balance and perceived assignment burden. A single‑group pretest–posttest design was implemented on a cardiac adaptable acuity unit at Stanford Health Care over a 12‑week period, encompassing 168 shifts from December 14, 2025, to March 7, 2026. The intervention, implemented with 11 charge nurses, combined structured charge nurse education with an optimized Epic Reporting Workbench tool incorporating dynamic …

Evidenced-Based Practice Guideline Development: The Addition Of Adjunctive Dexmedetomidine In Brachial Plexus Blocks For Upper Arthroscopic Surgery, Mylene Louail

Doctor of Nursing Practice Scholarly Projects

Dexmedetomidine (DEX) is an alpha-2 adrenergic agonist increasingly studied as an adjunct in brachial plexus blocks (BPBs) to enhance postoperative pain management. This project examines the efficacy of DEX as an adjunct in BPBs for upper extremity arthroscopic surgeries, focusing on its ability to extend analgesia duration, reduce opioid use, and enhance patient satisfaction. With analgesic and sedative properties, DEX can improve postoperative pain management with minimal side effects, providing shortened hospital stays, decreased costs, and better patient outcomes. Using the Iowa Model for evidence-based practice, baseline data on postoperative pain, analgesia duration, and opioid use will be collected from …

Nurse-Driven Palliative Care Screening Tools In The Icu, Olivia Sarkis Bsn, Rn, Fiona Hill Bsn, Rn, Isak Madden Bsn, Rn

Nurse Residency

PICOT Question: In adult ICU patients, how does implementing a nurse-driven palliative care screening tool, compared to provider-discretion palliative care consultation, affect rates of palliative care consultation in the ICU?

Safety Practices Regarding Oral Nimodipine Administration, Hannah Linsky Bsn, Rn, Nathan Mendoza-Connell Bsn, Rn, Perla Moguel Bsn, Rn, Andrew Vachon Bsn, Rn

Nurse Residency

PICOT Question: In adult patients with subarachnoid hemorrhage who are unable to swallow, does pharmacy prepared nimodipine oral solution administered via EnFit syringes, compared with bedside aspiration of nimodipine capsule solution using a blunt needle into syringes, reduce medication administration errors during hospitalization?

Remimazolam As A Sedative For Endoscopic Procedures: A Scoping Review, Hamzha Aysheh, Megan Henderson, Megan Hinkle, Sara Holton, Spencer Turner, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Propofol is commonly used for procedural sedation during endoscopic procedures because of its rapid onset and short duration; however, its use is frequently associated with adverse effects such as hypotension, hypoxemia, respiratory depression, bradycardia, and injection site pain. As diagnostic endoscopic procedures continue to increase, particularly among older and medically complex patients, there is a growing need for sedative agents that provide effective sedation while minimizing perioperative risk. Remimazolam, a novel ultra–short-acting benzodiazepine metabolized by tissue esterases, has demonstrated favorable hemodynamic stability and a reduced adverse effect profile in recent literature. The purpose of this evidence-based quality improvement project …

Discharge Education Bundles And Evaluating The Effect On Readmission And Satisfaction Rates: A Scoping Review, Jane Campo Bsn, Rn, Charlotte Edwards Bsn, Rn, Mary Catherine Hall Bsn, Rn, Sarah Moore Bsn, Rn, Allison Walker Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Transitioning children with a chronic medical condition from hospital to home is a critical and difficult process, leaving many families feeling anxious and unprepared. Nationally, 1 in 7 pediatric patients are readmitted within thirty days, making readmission rates an important quality indicator with both clinical and financial implications. To address these challenges, multiple discharge bundles have been developed; however, their effectiveness has not been consistently evaluated. The aim of this project is to summarize the current literature and highlight its positive outcomes, with the intention of promoting further research, reducing 30-day readmission rates, and increasing parental satisfaction (Shermont et …

Impact Of Nitrous Oxide Analgesia On Labor Experience, Kierra Jones Rn, Bsn, Elyzabeth Morales Rn, Bsn, Lanitra Ray Rn, Bsn, Rhonda Johnson Dnp, Cne, Cnm, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Nitrous oxide (N₂O) has re-emerged in the United States as a labor analgesia option that supports mobility, autonomy, and patient-centered care. As nurses increasingly support low-intervention and physiologic birth approaches, understanding the effectiveness and safety of nitrous oxide for low-risk laboring individuals is essential. This scoping review examines current evidence on nitrous oxide use during labor, focusing on maternal pain management, satisfaction, and neonatal outcomes to inform evidence-based nursing and midwifery practice.

Methods

A scoping review was conducted using PubMed, CINAHL Complete, and the Cochrane Library between September and October 2023. Inclusion criteria consisted of English-language studies published within …

A Program Evaluation Of A Family-Based Healthy Weight Program For Overweight And Obese Children And Their Families, Ashley Heimbouch, Margaret Platel, Kelly Betts

Doctor of Nursing Practice Projects: College of Nursing

This project’s purpose was to complete a program evaluation of the Building Healthy Families (BHF) program to determine its effect on children and their families’ health outcomes. The specific aims of success were 1) an improved perception of health-related quality of life for children and parents and 2) decreased body mass index (BMI) percentiles for age and sex in children from baseline measurements and scores compared to measurements and scores at 3 months and 6 months of program completion. The project was completed in a community setting on the University of Nebraska Medical Center’s Western Nebraska campus, and the population …

How Employment-Based Clinical Experience During Undergraduate Education Influences Transition To Practice: A Qualitative Systematic Review, Seung A. Park, Marion Eckert, Rebecca Sharp, Belinda Clark, Micah D.J. Peters

Research outputs 2022 to 2026

Aim: To synthesize qualitative evidence on the experiences of undergraduate nursing students and new graduate nurses engaged in formal paid employment models or health-related work during their undergraduate studies, to examine how these employment-based clinical experiences influence their transition to nursing practice, and to identify elements that facilitate or hinder this transition. Design: Qualitative systematic review. Methods: Searches were conducted in MEDLINE, Embase, Emcare (Ovid), CINAHL Complete (EBSCOhost), ERIC (ProQuest), and gray literature sources, including ProQuest Dissertations and Theses and Google Scholar. No date or country limits were applied, although only English-language studies were included. The review followed JBI methodology …

Key Insights From The International Icu Diary Conference 2025, Peter Nydahl, Bev Ewens, Anne Sophie Debue, Xavier Fiorilla, Kristin Gabriel, Alessandro Galazzi, Louise Gallie, Nikolas Groth, Carly Hickey, Mark Hudson, Fiona Lynch, Nicola Maxwell, Margo Van Mol, Caroline Renner, Louise Rose, Kate Tantam, Lioudmila Karnatovskaia, Christina Jones

Research outputs 2022 to 2026

We report on the 2025 International ICU Diary Conference that provided a comprehensive update on current knowledge, innovations and global practices related to ICU diaries. Held in a 6-week online format, the event featured 23 speakers and was attended by mean 69.7 (SD 20.5) participants per session. Topics included development of ICU diaries, use in special settings, digital diaries, survivors' and families' experiences, Post-Intensive-Care Syndrome and follow-up and implementation projects. Highlights were innovative solutions for digital diaries and the report of persons with lived and living experiences with diaries, changing the focus on humanising critical care. Relevance for Practice: ICU …

Digital Decoding Of The Multidimensional Pain Experience In People Living With Dementia, Kreshnik Hoti, Ipsit V. Vahia, Paola Chivers, Jeffery David Hughes

Research outputs 2022 to 2026

Background: Understanding how pain manifests in people living with dementia can facilitate pain management but evidence from large real-world studies is limited. Through digitally compiled large number of pain assessments, we explore how behavioural indicators manifest across all widely used domains of pain assessment. Methods: This is a population based observational study with data from aged care homes across Australia, New Zealand and the United Kingdom. Pain assessments were conducted over a period of 5.3 years in 89 230 residents living with advanced dementia. The primary outcome was to determine pain indicator occurrence across pain levels and explore their predictive …

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

Dissertations

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

A primary …

Exploring Policy Change To Support Early Diagnosis Of Congenital Heart Defects (Chd) In New Mexico, Kelsey Carson Leibenhaut

Doctor of Nursing Practice Scholarly Projects

Congenital heart disease (CHD) is not a new or rare problem; it has likely always been a leading cause of childhood morbidity and mortality and clocks in today as the most frequently occurring birth defect, affecting an estimated 1 in 100 newborns (CDC, 2025). Prior to the middle of the 20th century, there was little to be done about CHD, as no treatments existed. Everything changed with the advancement of options for surgical repair of CHDs, significantly prolonging lifespans and improving quality of life for affected individuals. Despite these incredible advancements, babies are born with CHD every day, leading to …

Navigating The Nicu Without Words: A Case Study Of A Spanish-Speaking Mother’S Healthcare Experience, Emma Norris

Poster Presentations

Research on NICU experiences largely focuses on majority-language families; non-English-speaking families are understudied (Cleveland, 2008). The Family Integrated Care model promotes parent-infant connection and shared decision-making to improve outcomes (Wreesmann et al., 2020). Language barriers impede parent-provider communication, increasing miscommunication and parental anxiety (Kynoe et al., 2020; Ardal et al., 2011). The purpose of this research is to explore communication experiences and barriers between English-speaking and bilingual NICU nurses and a Spanish-speaking NICU mother.

Exploring Student Feelings, Knowledge Related To Menstruation And Menstrual Education: A Cross-Sectional Survey, Ella A. Handel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Menstrual, reproductive, and sexual health education in the United States remains inconsistent in both content and delivery. This inconsistency often leaves adolescents underprepared for developmental milestones such as menarche and contributes to ongoing stigma and discomfort surrounding menstruation. This study examined participants’ feelings and perceptions related to menstruation and menstrual education. Using a cross-sectional descriptive survey design, a mixed-methods approach was employed to collect data from 29 college students aged 18 to 19 years at a large public university in Arkansas. Quantitative data from Likert-scale items were analyzed using descriptive statistics, while qualitative open-ended responses were reviewed and organized into …

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. …

The Prevalence Of Stress Fractures In Relation To Red-S Syndrome Among Various Sports In Collegiate Female Athletes, Lilianna G. Couch, Marilou D. Shreve

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: RED-S is a risk factor for bone stress injuries in female athletes. Athletes that compete in sports that involve repetitive movements of impact are prone to stress injuries. The treatment of stress fractures requires addressing all potential causes of the injury to accelerate healing and prevent reinjury. Since RED-S is a well-established risk factor for stress injuries, early detection of RED-S is crucial to prevent long term negative health consequences in athletes including the development of stress fractures. It is also confirmed that certain sports have a higher prevalence of reported stress fractures in female athletes such as cross …

The Effects Of Sugammadex Vs. Neostigmine On Intraoperative Heart Rate In Pediatric Patients Under Two Years: A Scoping Review, Saumel Abston, Jackson Cobb, Elle Dean, Tanner Dillard, Pauline Dinh, Dwayne Accardo Dnp, Crna, Faana, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Neuromuscular blockade (NMB) reversal is a critical component of anesthesia care, particularly in infants under two years of age who have immature autonomic regulation and heightened vagal tone, predisposing them to bradycardia. Neostigmine, the traditional reversal agent, is associated with parasympathomimetic effects such as bradycardia, requiring anticholinergic co- administration. Sugammadex, a selective relaxant binding agent, offers rapid and predictable reversal of aminosteroidal neuromuscular blocking agents with less cholinergic side effects. Although the safety profile of sugammadex is well established in older pediatric populations, limited evidence exists regarding its cardiovascular effects in infants under two years of age.

Methods

A …

Improving Access And Early Identification Of Anxiety Disorders Through Annual Gad-7 Screening In High Schools: A Scoping Review, Joshua Richard Yumul Bsn, Rn, Cindy Thao Msn, Rn, Justin Doyle Borden Bsn, Rn, Rebecca Lizette Johnston Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Background: Anxiety disorders affect nearly one-third of adolescents in the United States, yet many cases remain undiagnosed due to inconsistent screening and limited access to school-based mental health services. The Generalized Anxiety Disorder 7-item (GAD-7) questionnaire is a validated screening tool, but its routine use in high school settings is not well established.

Purpose: This scoping review aimed to synthesize current evidence on the use of the GAD-7 in high schools to support early identification of anxiety disorders and improve access to mental health care.

Methods: A comprehensive literature search was conducted using PsycINFO, ERIC, PubMed, CINAHL, and Google Scholar. …

The Prevalence Of Amenorrhea In Relation To Red-S Syndrome Among Various Sports In Collegiate Female Athletes, Ruby S. Holland, Marilou D. Shreve

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: RED-S is a common risk factor for amenorrhea in female athletes. Athletes that compete in high-intensity sports or without adequate caloric intake, are at risk for low energy expenditure which may disrupt hormonal balance. As development of RED-S is a well-established risk factor for amenorrhea, early detection and correction is crucial to prevent long term health consequences.

Purpose: The purpose of this research is to explore if there is a correlation between RED-S score and amenorrhea in female athletes.

Methods: An online survey was distributed to approximately 220 female athletes at the University of Arkansas using Qualtrics. The 69-question …

Tiny Tusks Internship: Factors That Affect Breastfeeding In Public, Caroline E. Bene

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this review was to explore factors that impact women’s decision to breastfeed in public or not. The PICOT question used was: ‘What Factors Affect Women’s Decision to Breastfeed in Public or Not?’ Two platforms, EBSCOhost and The National Library of Medicine, were used to identify 15 peer-reviewed journal articles on factors affecting women’s decision to breastfeed in public or not. The factors that impact a women’s decision on whether it is acceptable to breastfeed in public stems from the media stigmatizing that breastfeeding should be a private action. Research done yielded results of both positive and negative …

Exploring Perceived Structural Barriers And Access Related To Menstruation And Menstruation Education, Rylie Sisengrath

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Menstrual health is an important component of women’s health. However, many adolescents in the United States report feeling unprepared for menarche due to limited menstruation education. Menstruation education is limited, exclusively taught in schools with sex education courses, limiting the scope of female developmental education. Period poverty, limited access to menstrual education and hygiene products, continues to affect a large group of women. This study aimed to understand adolescents’ experiences with menstrual education, identify gaps in menstruation education, and explore structural and policy barriers affecting access to menstrual health resources. Using a cross-sectional survey with Likert-scale and open-response questions, quantitative …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Physical Activity Recommendations, Emma H. Foran

Honors College Theses

Working in healthcare settings that require patient handling is physically demanding - over 80% of providers involved in patient handling report work-related musculoskeletal disorders (WMSDs). Injuries or exacerbation of a previous injury may occur if the individual cannot tolerate heavy workloads. Injuries that cause lost work time or work restrictions impact the healthcare team, may alter quality of life, and impact employee income. A practical way to minimize these effects is to prevent WMSDs. Training providers to use proper body mechanics, practice patient handling, and engage in regular exercise designed to increase muscular strength and endurance through resistance training improves …

Community Vitality: Establishing Blue Zone Based Education For Elementary Students, Eliza G. Heinrich

Honors College Theses

Blue Zones are areas of the world where people live longer and healthier lives. These areas share several key characteristics called the Power 9 (Buettner & Skemp, 2016). The goal of this study was to increase general knowledge of Blue Zones as well as the implementation of healthy habits to increase the longevity of the population of Calloway County, Kentucky through educational sessions of elementary students. Researchers involved in this study asked participants to fill out a pre-test to gauge knowledge of Blue Zones. Participants then underwent several educational sessions and activities surrounding the Power 9. Participants were then asked …

Tiny Tusk Internship: Gut Instincts: A Review Of Literature On The Impact Of Breastfeeding On The Infant Gut Microbiome, Rayla Payne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to investigate both the short- and long-term benefits that breastfeeding has on the infant gut microbiome. The PICOT question was: In full-term infants, how does exclusive breastfeeding compared to mixed or formula feeding influence the diversity and composition of the gut microbiome throughout the first 12 months of life? For this research, EBSCOhost, CINAHL, and the National Library of Medicine databases were searched to find relevant studies and systematic reviews. Terms such as “breastfeeding and infant gut microbiome” were used to conduct the search. Other terms used included “breastfeeding OR formula feeding”, “human …

Total Intravenous Anesthesia Versus Inhalation Anesthesia For The Prevention Of Post Operative Nausea And Vomiting: A Comprehensive Literature Review, Francesca A. Diflorio

Nursing Undergraduate

Postoperative nausea and vomiting (PONV) is a common complication defined as the occurrence of nausea and/or vomiting within the first 24–48 hours following surgery. While nausea represents the subjective urge to vomit, vomiting involves the physical expulsion of gastric contents; both remain among the most distressing postoperative complications, strongly associated with the type of anesthesia administered. According to Timerga and Befkadu (2024), the incidence of PONV ranges from 25% to 30% in the general surgical population and may increase to as high as 80% among high-risk patients. Complications resulting from PONV can further prolong recovery and negatively impact patient outcomes, …