Nursing Commons^™

Sustainable Healthcare In Action: Six Practice Changes That Make A Difference, Christine Catling, Carol Crevacore, Melisa Young, Wayne Varndell, Jack Cornish, Sue Sheppard-Law, Elaine Correia Moll

Research outputs 2022 to 2026

Problem: Planetary health, linking the well-being of human populations with the stability of Earth's natural systems, is increasingly recognised as essential for all organisations. Healthcare is a major contributor to environmental harm, responsible for an estimated 4.4% of global net emissions. As a result, healthcare workers have an important role in driving sustainable, low-waste practices within clinical settings. Aim: This paper outlines six practical, evidence-informed changes that can be introduced within healthcare organisations: adopting reusable tourniquets, reducing unnecessary glove use, recycling medication blister packs, promoting reusable nappies, using reusable or compostable blueys, and reintroducing stainless steel holloware. Discussion: These examples …

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Publications 2026-present

No abstract provided.

Joint Cancer Nurses Society Of Australia–Clinical Oncology Society Of Australia Position Statement On The Contribution Of Nurses To Cancer Survivorship Care In Australia, Raymond J. Chan, Gemma Mcerlean, Fiona Crawford-Williams, Carla Thamm, Carmel O'Kane, Nicolas H. Hart, Gillian Blanchard, Anne Mellon, Justin Hargreaves, Mei Krishnasamy, Michael Jefford

Research outputs 2022 to 2026

Aim: To describe the development, consultation, and endorsement process for a joint position statement from the Cancer Nurses Society of Australia (CNSA) and the Clinical Oncology Society of Australia (COSA) regarding the contribution of nurses to cancer survivorship care in Australia. Methods: A development team of nursing and oncology experts (n = 11) was convened in September 2025. The draft position statement was informed by key literature, including the COSA Model of Survivorship Care, Australian Cancer Plan, a modified Delphi study defining nurse capabilities in survivorship care, and an overview of systematic reviews on nurse-led care models. A consultation survey …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

Correlates Of Recovery Capital Among Women In Jails: Leveraging A Dimensional Recovery Framework, Amanda Fallin-Bennett, Martha Tillson, Jaxin Annett, Hartley Feld, Michele Staton

Nursing Faculty Publications

Background: Recovery capital encompasses internal and external factors that support recovery from substance use disorder, such as employment, social support, and physical and mental health. There is a need for more research on recovery capital among women who are incarcerated, who often face complex barriers to recovery, such as poverty, unemployment, and histories of trauma.

Methods: Women (N ¼ 900) were recruited from Kentucky jails as part of the broader NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative project. Measures from baseline interviews (during incarceration) were selected in alignment with the Substance Abuse Mental Health Service Administration (SAMHSA)’s four …

“Being Treated As The Expert:” A Blueprint For A Community Advisory Board Approach To Elevate The Voice Of People With Living Experience With Substance Use In Academic Research, Trevor Moffitt, Survivors Union Of The Bluegrass, Bryson Henson, April M. Young, Sharon L. Walsh, Rachel Vickers-Smith, Junior Cruz, Jeremy Byard, Brook West, Amanda Fallin-Bennett

Nursing Faculty Publications

Introduction: Researchers have traditionally engaged Community Advisory Boards (CABs) to meaningfully involve community members in the research process. However, CABs are often formed only after a grant is funded, leading to criticisms of functioning merely as “ethical approvers.” For substance use researchers, the inclusion of people with living experience (PWLE; current experience with drug use) across all stages of research is especially important as they have historically been the experts in the needs of their community.   Methods: In response to this need for community engagement in research, the University of Kentucky, in partnership with a local recovery community center (RCC; …

Coalition Building And Citizen Science For Radon Risk Reduction, Stacy Stanifer, Kathy Rademacher, Whitney Sedio, Naomi Cheek, David Gross, Caitlyn Curtis, Amanda Thaxton-Wiggins, Mary Kay Rayens, Ellen J. Hahn

Nursing Faculty Publications

We evaluated the implementation of local coalitions led in partnership with citizen scientists, community-based organizations, and public libraries in four rural communities to lower exposure to radon in the home. The objectives were to (1) describe the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) of four radon coalitions, and (2) compare RE-AIM factors among citizen scientists who participated in the coalitions and those who did not. A larger community-engaged research project embedded coalition building using a citizen science approach. Three of the four coalitions focused on health and wellness more broadly (18–34 members); one focused solely on radon (10 members). Coalition membership and activities varied …

Evaluation Of A Tobacco Treatment Specialist Training Program Targeted To Behavioral Health Professionals, Chizimuzo T. C. Okoli, Sarret Seng, Bassema Abu Farsakh, Emily Koyagi, Heather Beck, Audrey Darville

Nursing Faculty Publications

Tobacco use remains disproportionately high among adults living with mental illnesses (MIs), contributing to excess morbidity and mortality, particularly in high-burden states such as Kentucky. Behavioral healthcare providers are well-positioned to address this disparity but often lack formal training in evidence-based tobacco treatment. Tobacco Treatment Specialist (TTS) training provides healthcare providers with skills to deliver evidence-based tobacco treatment; however, traditional TTS training models often rely on synchronous, in-person or live virtual formats, which may limit accessibility for some healthcare workforces. Asynchronous, web-based delivery models may reduce these barriers. This study evaluates a targeted, asynchronous TTS training program designed for providers …

Artificial Intelligence And Mental Health: Promise, Pitfalls And Ethical Priorities, Maharaj Singh

College of Nursing Faculty Research and Publications

Mental health conditions are prevalent across the lifespan, yet workforce shortages, long waiting times, and fragmented systems mean many people never receive timely, evidence‑based care. Artificial intelligence (AI), including machine‑learning classifiers and large language models (LLMs), is being explored to support earlier detection, closer symptom monitoring and scalable psychoeducation. Early studies suggest AI can surface risk signals from language, sleep/activity traces and clinical notes; summarise complex records for clinicians; and deliver structured self‑help at scale. At the same time, safety, bias, privacy and accountability concerns remain salient.

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

Honors Undergraduate Theses

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

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

Recruitment Agency-Mediated Onboarding, Acculturation, And Contract Completion Among Internationally Educated Nurses In The United States: A Questionnaire Survey, Jasper Erwin Tolarba, Jennifer Orbeso, Reynaldo R. Rivera

Nursing Faculty Publications

Background

Internationally educated nurses play a vital role in addressing global nursing workforce shortages and supporting healthcare systems across many high-income countries. As international nurse migration continues to increase worldwide, effective transition, onboarding, and acculturation practices have become important determinants of workforce integration and retention. In the United States, internationally educated nurses comprise a growing segment of the nursing workforce; however, variability in onboarding practices may affect successful integration and retention.

Aim

To examine recruitment agency–mediated onboarding and acculturation practices and their association with contract completion among internationally educated nurses in the United States.

Design

Cross-sectional descriptive correlational study.

Methods …

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

2026

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 device …

Quadriceps And Ankle Weakness In Inclusion Body Myositis: Impact On Descending Balance Control And Rehabilitation Strategies - A Systematic Review, Woohyoung Jeon, Ashley Dalby, Melinda Hermanns, Manuel Lubinus

Nursing Faculty Publications and Presentations

Background

Inclusion Body Myositis (IBM), a progressive neuromuscular disorder, is characterized by quadriceps and ankle muscle weakness, leading to impaired balance control and increased fall risk during functional activities. Existing research highlights inconsistent evidence on fall risk reduction and a lack of standardized rehabilitation protocols, creating gaps in effective management. This systematic review aims to synthesize evidence on the impact of muscle weakness on balance and fall risk and evaluate rehabilitation strategies, including task-specific interventions, to improve functional outcomes in IBM patients.

Methods

Following PRISMA guidelines, we conducted a systematic search of MEDLINE, Embase, and the Cochrane Library from inception …

A Qualitative Analysis Of Counseling And Nurse Practitioner Trainee Experiences Engaging With An Integrated Behavioral Health (Ibh) Training, Alexander M. Fields, Margaret Emerson, Stephanie Burge, Jill R. Reed, Therese L. Mathews Ph.D., Aprn, Bcba-D, Abby L. Bjornsen

Teaching and Supervision in Counseling

Integrated behavioral health (IBH) is recognized as the standard for holistic healthcare, addressing the intersection of mental and physical health. As IBH gains prominence, graduate healthcare programs must equip students with strategies to meet its demands. However, limited research exists on training methods that address diverse professional identities and the unique needs of graduate students. Our novel IBH training incorporates interprofessional education (IPE) through modules and simulations grounded in Bandura’s (2001) social cognitive theory. We explored the experiences of 12 counseling, family nurse practitioner, and psychiatric/mental health nurse practitioner students through focus groups. Through interpretative phenomenological analysis (IPA), we analyzed …

Co-Developing Strategies For Leprosy Management In Malaysia: A Transdisciplinary Research Approach Involving Individuals Affected By Leprosy And Other Stakeholders, Norana Abdul Rahman, Vaikunthan Rajaratnam, Ruth Mh Peters, Marjolein Bm Zweekhorst, Pamela Wright Phd, Ms, Med, Rn, Cen, Karen Morgan, Mohamed Rusli Abdullah

Publications

Despite Malaysia's low leprosy prevalence, new cases continue to emerge in rural and Indigenous communities. National strategies often prioritise elimination and surveillance, while overlooking the needs and challenges of individuals affected by leprosy and those managing their care. This study employed a transdisciplinary research approach, guided by the Dialogue Model, to co-develop context-specific strategies to improve the lives of those affected through participatory engagement with both groups. Conducted across three high-burden states in Peninsular Malaysia, the research involved a desk review and stakeholder mapping, followed by 40 in-depth interviews with affected individuals and other stakeholders. These were complemented by a …

Staff Education To Improve Patient Outcomes Through Bedside Shift Report In A Skilled Nursing Facility, Ngum Avwontom

Walden Dissertations and Doctoral Studies

Abstract Problem: Inconsistent shift handoff communication in skilled nursing facilities (SNFs) contributes to adverse patient outcomes, including medical errors, falls, and pressure ulcers. Bedside shift reports (BSRs) are an evidence-based, patient-centered strategy to mitigate these risks, yet implementation at the project site was inconsistent. Methods: This staff education project implemented a standardized BSR program in a 100-bed SNF over seven weeks. The intervention trained 18 nursing staff (RNs, LPNs, CNAs) on BSR using the Situation-Background-Assessment-Recommendation (SBAR) communication framework. A pre- and post-test design was used to evaluate the impact on staff knowledge, shift report duration, and patient safety outcomes, including …

For Evidence-Based Suicide Risk Assessment, Monica Molah

Walden Dissertations and Doctoral Studies

This clinical practice guideline (CPG) project was developed to address a practice gap regarding the lack of systemic approach to suicide assessment in adult patients. This Doctor of Nursing Practice (DNP) project identified a significant gap in care at a private mental health clinic, which lacked a consistent, evident-based approach to suicide risk assessment. The inconsistency increased the likelihood of under-identifying at risk patients, posing substantial medical-legal and patient safety concerns. The practice-focused question guiding this project was: Does the evidence support the development of a CPG for suicide risk screening that receives an AGREE II quality score by an …

Improving Timely Administration Of Scheduled Short-Acting Insulin In Hospitalized Diabetic Patients, Edward S. Qu

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to improve compliance with the administration of scheduled short-acting insulin within 30 minutes of point-of-care blood glucose testing among hospitalized diabetic patients.

Background

This project was implemented in an inpatient hospital unit caring for patients with diabetes who require scheduled short-acting insulin. Internal audit data showed that compliance with administering insulin within 30 minutes of blood glucose testing was approximately 60%, indicating an opportunity to improve workflow and care coordination.

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement method was used to guide the project. Baseline data were collected from electronic health record …

The Therapeutic And Physiological Effects Of Citrus Peel Extraction On Helicobacter Pylori Bacteria, Sara Saeb Rasheed, Rawnaq Z. Fadhil, Marwah Amer Qamandar, Salah M.M. Al-Chalabi

Al-Esraa University College Journal for Medical Sciences

The antibiotic resistance has emerged as a growing international concern affecting not only human health but also the environment, animal population, and global economy. The increasing prevalence of antibiotic resistance poses a serious and escalating threat to public health. This problem is further exacerbated by the limited development of new antibiotic, high production costs, and risks about its side effects. Identifying novel antibiotic agents is crucial for managing fungal and bacterial infection. Consequently, numerous natural compound have been investigated as potential alternative therapies. Plant extracts are valuable source of bioactive compounds and represent a promising strategy to control pathogenic microorganisms. …

Care Navigator Role In The Management Of Patients' Access At A Mental And Behavioral Health Clinic, Bernadine Grinage

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Bernadine Grinage has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Sue Bell, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Abstract The practice issue cited by clinical staff of a rural mental and behavioral clinic (RMBHC) was fragmented versus holistic care, increase emergency room (ER) visits, inadequate access and patient attrition rate …

Black Nurses In Leadership Roles: Resources And Opportunities Needed For Advancement, Patrick W. Petty

Walden Dissertations and Doctoral Studies

The lack of diversity in healthcare management is a social issue that can lead to increased implicit bias and adverse effects on patient care and quality. This study examined the underrepresentation of Black RNs in leadership roles within healthcare. The purpose of this qualitative descriptive study was to explore the perceptions of Black RNs in leadership regarding the opportunities and resources they need for advancement, as outlined in three research questions. A sample of 10 BSN nurses responded to 10 semi-structured interview questions, grounded in critical race theory. Codes were developed from responses, resulting in nine themes and 16 sub-themes, …

Staff Education On Evidence-Based Practice On External Factors That Impact Management Of Chronic Hypertension In African American Patients, Stella Ngozi Paul

Walden Dissertations and Doctoral Studies

This doctoral staff education project was developed to address a significant gap in nursing practice, specifically the limited knowledge of outpatient clinical staff regarding cultural, social, and health literacy factors that influence the management of chronic hypertension in African American (AA) patients. Through this project, I aimed to equip clinical staff with evidence-based, culturally competent strategies to promote equitable, patient-centered care. This project was guided by the following practice-focused question: Can an evidence-based practice educational session on how external factors impact the management of chronic hypertension in the AA population enhance staff knowledge and understanding? Using the analysis, design, development, …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Efikasi Diri Dalam Melakukan Diet Sehat Pada Masyarakat Desa Cipacing, Sumedang, Hilmi Khairun Nisa, Neti Juniarti, Adelse Prima Mulya

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. Noncommunicable diseases (NCDs) account for 57 million deaths (71%) worldwide and 73% of all deaths in Indonesia. Eating habits are one of the factors contributing to the incidence of NCDs. In the process of improving a healthy lifestyle, including a healthy diet, self-confidence or self-efficacy in maintaining a healthy diet is necessary.

Objective. This study aims to identify the level of self-efficacy in maintaining a healthy diet among the community in Cipacing Village, Sumedang.

Methods. This study was conducted using a quantitative descriptive research design among the community of Cipacing Village, Sumedang Regency, West Java. The sample was …

Understanding Breastfeeding Practices In Tennessee: Goals, Duration, And Reasons For Discontinuation, Amir Alakaam, Chia-Lin Chang, Hannah Jeffery

Journal of Appalachian Health

Introduction: Breastfeeding is widely recognized as the optimal source of infant nutrition, offering many health benefits.

Purpose: The purpose of this study was to examine goals, exclusivity, and duration of breastfeeding and explore factors that influence breastfeeding practices among individuals in Tennessee (TN).

Methods: A cross-sectional study was conducted among individuals (N = 1,249). Participants were recruited and data were collected from June – September 2021. The data were entered and analyzed from September 2022 – March 2023. Descriptive statistics, chi-square test, and ANOVA were used to analyze the data and identify associations between variables.

Results: About 32% of the …

Nurses' Implicit Bias Toward Older Adults: A Mid-Range Nursing Theory, Jennifer T. May Phd, Rn, Anp-Bc, Hanne Dolan, Jessica G. Rainbow

Publications

This article describes the development of the Nurses' Implicit Bias Toward Older Adults Mid-Range Nursing Theory, which explains how biased care arises and affects older adults. Drawing from Pepper's contextual-development worldview, Parse's Humanbecoming Paradigm, and an emancipatory perspective, the theory integrates implicit social cognition to explain how nurses' backgrounds and unconscious processes influence clinical practice. Key "mitigation points" are identified for targeted interventions to address bias. This framework provides a foundation for future research on implicit bias in nursing, with implications for equitable health care delivery and improved older adult patient outcomes, supporting the advancement of nursing science and professional …

Precision Education In Health Sciences Education: A Call-To-Action For Developing An Interprofessional Strategy, Arvie Vitente, Jennifer Bosworth, Robert Sweet, Rebecca Cozzi, Christopher Galloway, Piotr Szczurek, Melanie Obispo-Young, Eron Bozec, Erica Brkovic, Tina Bobo, Jennifer Lubinski

Philippine Journal of Physical Therapy

Introduction. Growing learner diversity, expanding biomedical knowledge, and rapid clinical digitization have exposed the limits of on-size-fits-all health sciences training. Competency-Based Education (CBE) has sharpened the focus on outcomes, yet many programs still move learners through fixed sequences, infrequent assessments, and retrospective remediation. Precision Education (PE) offers a complementary, data-enabled approach that uses learning analytics, artificial intelligence (AI), and continuous feedback loops. Embedded within CBE, PE converts competencies from static milestones into dynamic trajectories that can be measured, visualized, and adjusted in real time across the curriculum. This abstract highlights the need for an interprofessional strategy to design, fund, and …

Teach-Back Techniques In Telehealth: A Review And Insights For Future Directions, Faith A. Albertson, Waka Alnakhi, Shanikque Barksdale, Shannon Stark Taylor, Shaniece Criss, Daniela B. Friedman Ph.D., Karen A. Kemper, Lorie Donelle Phd, Rn, Fcan, Wanda Thompson, Phyllis Macgilvray, Nabil Natafgi

Publications

Background and objectives: The rapid expansion of telehealth during the COVID-19 pandemic has created new challenges in patient-provider communication due to the absence of in-person interactions and visual cues. Teach-back, a method where patients repeat information to confirm understanding, is a promising tool for improving communication in virtual care. This review evaluates the effectiveness of teach-back techniques in telehealth settings.

Methods: A search of four databases (CINAHL, EMBASE, PsycINFO, PubMed) was conducted, yielding 10 studies that met the inclusion criteria. The article inclusion/exclusion criteria consisted of the following: (1) telehealth services topic; (2) direction provision related to teach-back; and (3) …

Pm2.5 And Respiratory Symptoms Among Primary Schoolchildren In Bangkok, Thailand: A School-Based Cross-Sectional Study, Monrudee Chokprajakchad, Dongruethai Buadong, Lawan Singhasai, Chayannan Jaide

Journal of Health Research

Background: Exposure to fine particulate matter (PM2.5) has been linked to adverse respiratory health in children. However, limited studies in Bangkok have examined the combined influence of environmental exposure and health perceptions. The objective of this study is to investigate the association between PM2.5 concentrations and respiratory symptoms among primary schoolchildren aged 7—12 years in Bangkok, across districts categorized by differing levels of air pollution.

Methods: A cross-sectional study was conducted among 388 primary schoolchildren in Bangkok, recruited through cluster sampling from districts classified into three PM2.5 pollution zones based on data from the Pollution Control Department. Respiratory symptoms were …

Mental Health First Aid Certification's Impact On Filipino Nurses' Ability To Increase Personal Help-Seeking Behaviors, Self-Awareness Of Health Changes, And Improved Self-Connection, Maria Elena Holguin, Brenda Marshall, Faith Atte, Katherine J. Roberts

School of Nursing Faculty Scholarship and Creative Works

Background

Post COVID-19, almost 50% of nurses reported severe depression, and over 30% moderate to severe anxiety. Nurses from minority racial and ethnic backgrounds, including Filipino nurses, accounted for more than 54% of COVID-related deaths, despite comprising only 24.1% of the nursing workforce. Filipino nurses, making up only 1% of the U.S. population, comprise 4.5 % of the nursing workforce and face significant barriers to seeking mental health services, including stigma, a sense of shame, and adherence to cultural values that view mental illness as unacceptable.

Aim 

To assess the impact of Mental Health First Aid (MHFA) certification among Filipino …