Nursing Commons^™

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 …

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 …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …

Congolese Mothers' Beliefs That Influence Health-Seeking Behaviors For Their Infants., Shawn Meiman

Electronic Theses and Dissertations

In 2024, approximately 100,000 refugees were admitted to the United States, with 20% coming from the DRC, while Kentucky continues to rank fourth in the country for refugee resettlement. The increasing number of Congolese refugee children in the United States and Kentucky necessitates a greater understanding of these beliefs and practices to ensure equitable, quality, and culturally informed health services. The purpose of this study was to explore Congolese refugee mothers’ culturally and socially situated beliefs, perceptions, practices, and resources related to health care that may influence their views and practices of preventive well-child health care for their infants in …

The Role Of Psychological Capital And Case Management Intensity In Patient Activation In Permanent Supportive Housing Residents., Sarah J. Carter

Electronic Theses and Dissertations

This dissertation explores patient engagement with health, or patient activation, in the formerly homeless population housed in Permanent Supportive Housing (PSH) and receiving case management support. Research is limited on patient activation in PSH residents; consequently, there is minimal understanding of factors contributing to one’s attitudes and behavior towards health care in this group. Psychological Capital refers to the components of hope, self-efficacy, resilience, and optimism. Research in other marginalized groups indicates increasing psychological capital may improve health behaviors. Case management provides support to PSH residents and forms of social support have been associated with improved health outcomes. Applying the …

Reducing Operating Room Turnover Times Through Standardized Workflow, Trinity H. Darnell

Doctor of Nursing Practice Final Project Abstract

Prolonged operating room (OR) turnover times (TOTs) contribute to surgical delays, decreased case volume, and inefficiencies that negatively affect patient care and hospital operations. Lack of coordination in turnover processes and communication among staff are common contributors to extended TOTs. The purpose of this project was to reduce turnover times by implementing a standardized workflow carried out by efficiency teams composed of OR float staff. This project took place in the surgical department of a hospital in Sugar Land, Texas, using a single group pretest-posttest design. Baseline data was collected for 12-weeks prior to implementation and compared to 12-weeks of …

Objective Structured Clinical Examination (Osce) For Interscalene Brachial Plexus Block Utilizing Ultrasound Guidance And Landmark Technique, Madison Mize, Mckayla Moore, Peyton Shell

Doctoral Projects

The purpose of this doctoral project was to create learning and evaluation tools for interscalene brachial plexus blocks (ISBPB) to be used by certified registered nurse anesthetists (CRNAs) and students in the Nurse Anesthesia Program (NAP) at The University of Southern Mississippi (USM). ISBPB is a regional anesthesia technique used to provide anesthesia for procedures of the shoulder and upper arm. CRNAs and students can use these tools to refresh their current knowledge and enhance their regional anesthesia skills.

The objective structured clinical examination (OSCE) and cognitive aid for ISBPB utilizing landmark and ultrasound-guided techniques were evaluated by the USM …

Evaluation Of Migraine Treatment In The Emergency Department, Laura Porben Guzman, Erika Dittmar, Thomas J. Wolfel, Jessica Y. Justiz, Allison Vargas, Stephanie Palma

Nursing & Health Sciences Research Journal

Introduction: Migraines account for approximately 1.2 million U.S. emergency department (ED) visits annually, yet fewer than 25% of individuals achieve sustained relief, underscoring the need for more effective, standardized care. The American Headache Society recommends first-line ED therapy with intravenous fluids, nonopioid analgesics, and antidopaminergic agents; if inadequate, escalation to triptans or dihydroergotamine is appropriate, with adjuncts such as magnesium or valproic acid. Opioids are discouraged due to limited efficacy and safety concerns. We evaluated the impact of implementing an evidence-based ED migraine pathway following provider education.

Methods: We conducted an observational pre-/post-intervention quality improvement project (January–April 2025), including 100 …

Mental Health In Adult Oncology Patients, Jenna Pope

Capstones

Adults with cancer suffer from mental challenges that frequently go under diagnosed and under treated (Fernando et al., 2023). This can lead to lower quality of life, resulting in reduced adherence to treatment, more frequent hospital stays, increased healthcare costs, and increased mortality rates (Matthews et al., 2025). There are currently no policies on mental health screening for adult oncology patients at every outpatient appointment. By consistently utilizing standardized screening tools such as the PHQ-9 and GAD-7 during all oncology appointments, this can close the gap in policy to address mental health needs of these individuals. It is vital to …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.