Capstone & Scholarly Projects: Education & Leadership in Healthcare

Benson-DeVries, L. (2024). Problem: Local anesthetic use during surgical/medical procedures has increased because local anesthetics are more commonly used as a treatment modality to control postoperative pain. Complication rates from the use of local anesthetics are rare but adverse events of local anesthetic systematic toxicity (LAST) do occur. A knowledge gap was found during a needs assessment in identifying signs, symptoms, and treatment of LAST.
Intervention: Staff caring for clients receiving local anesthetics participated in a pre-intervention survey assessing their knowledge of LAST, took a 45-minute educational secession, and participated in a followup post-intervention survey four weeks later.
Measures: The survey tool developed for this project included 11 questions. Questions 1-3 measured perceived knowledge using a four-point Likert scale; questions 4-6 were multiple choice questions about recognizing LAST; questions 7-9 were multiple choice questions about signs and symptoms of LAST; and
questions 10-11 pertained to the treatment of LAST. The post-intervention survey was identical to the pre-intervention survey and also included question 12, which used the four-point Likert scale to assess the value of the educational offering.
Results: Nine responses were received from the pre-intervention survey and one response from the post-intervention survey. Descriptive statistics showed that prior to the intervention there was a deficit in knowledge. The one post-intervention response demonstrated full retention of knowledge.
Conclusions: This pilot study demonstrated the feasibility of using an educational approach to increasing staff knowledge of LAST. Staff working in areas where local anesthetics are used require knowledge about the signs, symptoms, and treatment of LAST. Staff who are knowledgeable increase the safety of clients and improve outcomes for organizations.

Buman, M. (2024). Interdisciplinary collaboration and communication are imperative to promoting perinatal safety and quality of care on inpatient labor and delivery units. Implementation of evidence based interdisciplinary fetal monitoring review can positively impact collaboration and communication; thereby improving outcomes. The purpose of this project was to implement fetal monitoring rounds with use of the California Maternal Quality Care Collaborative (CMQCC) algorithm for management of category II fetal heart rate tracings on a women and infants’ services unit at a large academic medical center. Prior to implementation, participants had the opportunity to complete a five-question pre-implementation survey which included questions related to interdisciplinary communication, collaboration, and agreement on necessary interventions as they relate to fetal monitoring. Following implementation, participants were given the opportunity to complete a seven-question post- implementation survey. Findings indicated that there was statistically significant increased interdisciplinary communication (p = .039, α = 0.05), increased interdisciplinary collaboration (p < .001, α = 0.05), and increased agreement on category II fetal monitoring strips with necessary interventions (p < .001, α = 0.05). Of all post-survey participants, 78% agreed that implementation of fetal monitoring rounds with use of the category II strip algorithm has assisted in increasing interdisciplinary review of fetal monitoring strips and has assisted in planning for patient care. Finally, there was an overall decrease in unplanned neonatal transfers to the neonatal intensive care unit (NICU) from a total of 13 in quarter four 2023 (pre-implementation) to a total of 6 in quarter one 2024 (post-implementation), a 54% decrease.

Brathwaite, A. (2024). Research has shown that infant and maternal mortality rates not only serve as indicators of the quality and accessibility of healthcare systems, but they also represent the overall health and well-being of a country. Over the years, the Black maternal health crisis has continued to paint a grim picture of health inequity in the United States as Black women are more likely to die from pregnancy-related causes than other populations. The increasing prevalence of such disproportionate maternal morbidity and mortality rates among Black women highlight a critical need to develop remedies that will mitigate patterns of social and health inequities. This proves especially necessary as statistics show that 60% of maternal deaths are preventable. While the intersection of lack of knowledge, limited access to care, and socioeconomic disadvantage combine to further impact Black maternal outcomes negatively, improving education and awareness about this crisis can serve an indispensable first step in addressing the issue and developing collaborative and interdisciplinary approaches that will increase community knowledge and maternal literacy to improve both health outcomes and healthcare practices that have contributed to this invisible dilemma.
In Tampa, Florida, statistics continue to be reflective of this public health concern. To enhance community knowledge about the many negative health outcomes experienced by this population, this study was developed to increase community awareness and maternal literacy through a self-paced online education course. Participants were comprised of adults 18 and up from various backgrounds and professions including community members, students, and other stakeholders. To analyze research data, a pre-post study design using a paired samples t-test was initially selected to estimate scoring changes. However, because no participants were successful in completing the course according to the intended criteria, no data was effectively collected to complete an analysis of knowledge acquisition. While the projected goals for this intervention were not met, many insights were gained yielding great potential for such methods to increase participation and community benefits in the future.

Burke, H. (2024). This project aimed to determine whether Whole Health (WH) education for primary care providers increased their awareness of WH, the benefits of VA-approved WH services, and increased referrals to the Introduction to WH class. The intervention consisted of one 30-minute educational session. Pre- and post-intervention surveys were utilized to assess providers' awareness of WH, the benefits of health coaching, tai chi, yoga, mindfulness, and the referral process. In addition, a focus was placed on an increase in referrals to Introduction to WH 15 days following the educational intervention and compared to the number of referrals 15 days before the educational intervention to gauge the effectiveness of the educational intervention in increasing referrals. Participants created a unique personal identification number (PIN) to match the pre- and post-intervention surveys and ensure confidentiality. Paired sample t-tests (N = 5) did not yield statistically significant results for awareness of WH, p = .06 and the benefits of VA-approved WH services, p = .06; however, they did show statistical significance for the referral process, p = .04. The number of referrals to Introduction to WH increased from zero fifteen days before the intervention to eight in the fifteen days following the intervention. Each of the six Likert scale questions resulted in positive changes between the pre- and post-intervention surveys, indicating the intervention had some impact in increasing providers' awareness of WH, the benefits of VA-approved WH services, and the referral process. The results suggest the importance of promoting and educating providers on WH, the benefits of VA-approved WH services, and the referral process. Overall, this project provided valuable insight into education's impact on primary care providers' awareness of WH, the benefits of VA-approved WH services, and the referral process.

Christensen, R. (2024). Problem: Nursing education plays a vital role in the development of nurses who can provide safe and competent care to patients. However, there is a gap between theoretical classroom learning and the practical skills gained in clinical settings. Simulation in education helps bridge this gap by supporting student learning and preparing them for clinical practice. Clinical simulation enables students to problem-solve and apply clinical knowledge in a safe, low-stress environment.
Intervention: This study evaluated the self-confidence levels of nursing students before and after controlled clinical simulation experience. Students completed pre and post simulation surveys to examine the effectiveness of clinical simulation.
Measures: Through pre- and post-surveys, this study compared nursing students' self-confidence levels before and after a code blue critical care simulation.
Results: Surveys were completed by 37 nursing students at a Midwest community college. Results of the study showed statistically significant improvement in reported self-confidence levels after the clinical simulation intervention with pre-survey scores (M = 28.9, SD 4.87) and post-survey scores (M = 36.3, SD 2.86); t (35) = 12.17, p < .001.
Conclusions: Findings indicate that incorporating controlled clinical simulation in nursing education can enhance reported self-confidence levels and better prepare nursing students as they transition into practice.

Clinton, B. (2024). Connecticut's local public health departments (LHDs) face significant challenges in analyzing comprehensive needs assessment data due to limited staffing and resources. This data is essential for identifying community-specific health needs and developing targeted interventions. However, the complexity and volume of the data make it difficult for LHDs to efficiently review and interpret it, hindering their ability to establish clear health priorities and effective interventions.
This project developed and piloted a tool to help LHDs analyze community needs assessment data, aiming to identify health concerns and develop targeted interventions. Initially, the lack of raw data shifted the focus to enhancing pre-interpreted data usability. An Excel-based tool using Visual Basic for Applications (VBA) was created to automate visualization and interpretation. The intervention had two phases: manually applying VBA for baseline comparison and developing a macro to automate the process. The manual process ensured data accuracy, while the macro development required learning VBA, scripting, and extensive testing. To validate the tool, a random sample of 300 questions from 585 was selected. The comparison between the original data and the macro tool-generated data showed a 100% agreement rate, with all 300 questions matching perfectly. The tool was reviewed by the Director of Health and tested against ten years of historical data, demonstrating reliability.
Key findings indicated that the tool significantly reduced the \me required for accurate data analysis, enabling better-informed decisions. While the primary development cost was time, the long-term benefits include substantial time savings. The project's strengths included its evidence-based approach, comprehensive testing, and the ability to empower LHDs with improved decision-making tools. Future steps involve expanding the tool's availability to other LHDs.

Gillespie, M. (2024). This study explored dissemination among Black behavior practitioners and communities through networking and marketing. The participants included two members who voluntarily completed the pre-intervention survey, received education on dissemination, and completed the post-intervention survey. Both surveys consisted of 10 Likert-scale questions and asked questions pertaining to the participants' attendance, knowledge, and comfort levels with networking and dissemination practices. The post-intervention survey included two additional questions directly correlated with the education provided. Due to the small number of participants, more research is needed to better understand the impact networking and marketing have on the dissemination of behavior analysis.

Harbison, S. (2024). Human papillomavirus (HPV) is a common sexually transmitted infection (STI) that can cause various cancers. While vaccination is recommended from age 11, rates remain suboptimal among men aged 27 to 45. This group has low HPV vaccine knowledge and negative psychosocial views inhibiting vaccination. This study aimed to increase HPV vaccination intention, improve knowledge, and modify psychosocial beliefs related to HPV, through an evidence based educational intervention grounded in the Health Belief Model and Theory of Planned Behavior. Men aged 27 to 45 (N = 32) employed at a Midwestern non profit were invited to participate. The project consisted of pre and post intervention surveys measuring HPV vaccine knowledge, vaccine intention, and psychosocial constructs, and an educational intervention. The educational intervention was comprised of an 11 part, 30 minute YouTube video series targeting known knowledge gaps and psychosocial factors per the literature, such as misunderstanding of adult vaccination recommendations. Data was collected using Google Forms. Descriptive statistics analysis evaluated the data. There were slight differences in knowledge, intentions, and perceived norms between pre (N = 2) and post intervention (N = 1) mean survey scores. Post-intervention mean scores were lower than pre intervention mean scores for subjective norms, perceived benefits, perceived behavioral control, perceived susceptibility, self efficacy, anticipated regret and attitudes. However, perceived susceptibility was higher in post survey results than in pre-survey results. Unforeseen circumstances affected the potential sample size. Due to minimal responses, no effectiveness could be determined. Future research should explore strategies to recruit a sufficient sample size and characterize factors influencing participation. Larger scale tests of engaging educational approaches are still needed to promote HPV prevention in the under vaccination of adult men.

Hart Higgins, L. A. (2024). Objective: Central Line-Associated Bloodstream Infections (CLABSIs) and Peripheral Venous Catheter-Related Bloodstream Infections (PVCRBSIs) pose significant risks to patients, often due to nonadherence to aseptic techniques and improper IV management. This project aimed to enhance protocol adherence and patient safety by providing nurses with evidence-based, gamified education on CRBSI prevention at a small community hospital in Tennessee.
Methods: The intervention, an innovative online virtual escape room, was designed to enhance nurses' understanding of hospital protocols. Participation was incentivized through a prize drawing. Data on protocol adherence were collected through direct observations and chart reviews before and after the intervention, with compliance measures focused on antimicrobial caps, dressing changes, IV tubing labels, and CRBSI rates.
Results: Scant participation led to no significant differences between pre- and post-intervention measures. Key findings include low compliance with antimicrobial cap use, paltry rates of properly labeled dressings and IV lines, and a concerning number of unobservable dressings, demonstrating poor overall protocol compliance.
Conclusion: However, low participation rates, likely due to insufficient leadership engagement and voluntary participation, limited the intervention's impact. Observational data underscored significant non-compliance with hospital IV management protocols, highlighting the urgent need for improved educational strategies and stronger leadership and staff engagement to enhance adherence to care bundles and protocols.

Lord, K. L. (2024). This project examined the impact of a focused faculty development training program on the self-perceived leadership skills of faculty participants in an undergraduate medical education setting. The study employed a pre- and post-intervention survey to measure the self-rated leadership skills of participants before and after completing three dedicated training sessions. Participants (N = 6) were asked to complete the survey and rate their self-perceived leadership skills using a four-point Likert scale on 12 survey items. After completing three synchronous training sessions, participants were then asked to complete the post-intervention survey, consisting of the same questions as the pre-survey, to rate their skills again. A unique four-digit identifier, self-selected by participants, was used to match results from the pre- and post-surveys for comparison. Results indicated all participants either remained static, or reported an overall increase, in their self-perceived leadership skills from pre-survey (M = 3.01, SD = 0.39) to post-survey (M = 3.57, SD = 0.27). While the limited sample size did not allow for the results to be tested for statistical significance, the average positive change in self-perceived leadership skills reported by participants after completion of the training sessions (M = 0.56, SD = 0.35) suggests the intervention had a positive impact on self-perceived leadership skills of faculty participants. Results of this project highlight the influence of leadership-focused professional development training for faculty, and could inform future leadership-development programming efforts in medical education programs.

March, A. (2024). Overview: The rate of infant mortality in the United States is greater than any other middle- and high-income countries in the world at an estimated 20,000 deaths annually, or 5.43 deaths per 1000 live births, with approximately 3,500 occuring during sleep. Problem: Approximately 80% of infant deaths, between January 1, 2015 and August 31,2023, in a Midwestern county included elements of unsafe sleep practices. Intervention: The educational intervention included two approximately 10-minute videos, related to safe infant sleep practices, available for participants to view during a 14-day window of time. Purpose: The purpose of this project was to provide evidence-based education and statistics to improve knowledge and behaviors related to safe infant sleep practice among parents/guardians with infants younger than 12 months, who were seen at a pediatric primary care department within a Midwestern hospital, over 30-days. Measures: A 33-question multiple-choice survey was to be implemented pre-intervention and as a follow-up 30-days after the start of the pre-survey/intervention. Analysis: The data that would have been utilized was a comparison of pre-educational survey answers and post-educational survey answers to determine if a statistically significant improvement occurred in the knowledge and behaviors related to safe infant sleeping practices. Results: This project was not implemented due to the inability to recruit any participants. Conclusion: Although the intervention did not take place, the educational materials may be shared with providers and organizations to be dispersed to assist in spreading awareness in this Midwestern community about safe infant sleeping practices.

Murray, A.M. (2024). Nursing simulation provides an interactive environment where student nurses can practice essential skills. However, the nature of simulation often provokes feelings of stress and anxiety which can interfere with learning. This study investigated the effect of a well-designed prebriefing on feelings of psychological safety during a simulation experience for undergraduate nursing students attending a private, four-year liberal arts northeastern United States college. The hypothesis was that a well-designed prebriefing session before simulation would decrease student feelings of psychological stress. Before their simulation, undergraduate nursing students (N = 49) completed a presurvey which contained 13 Likert scale questions regarding their feelings of psychological safety. Students then participated in a prebriefing session aligned with the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards. After the simulation experience, students completed a post-survey containing the same 13 questions to assess the impact of the prebriefing session on their stress and anxiety levels during simulation. Results indicated that the prebriefing was effective in reducing psychological stress and anxiety about participating in simulation. Pre- and post-survey question response means were compared using paired t-tests. Students felt reduced psychological stress at the p < .001 level for 11 out of 13 questions (84.6%) and at the p < .05 level for 1 out of 13 of questions. Only one question did not show significant results. Results from this project indicate that when conducting simulation exercises, the inclusion of a prebriefing aligned with INACSL standards can promote psychological safety in undergraduate nursing students, permitting them to focus on practicing skills during the simulation.

Nyoat, G. (2024). The war in South Sudan may have contributed to a culture of gun violence because of the trauma and suffering that South Sudanese youth experienced (Hynd, 2021). However, little is known about why young South Sudanese adults born in the West are also experiencing the same level of gun violence as their counterparts born in Africa. This project utilized evidence-based principles to design and implement a training session on gun violence for South Sudanese young adults living in a Midwestern US city, and measured participants' changes in knowledge on the areas of gun violence, firearm regulations, and safe storage. The results showed a statistically significant increase in knowledge, enabling a clearer vision of the underlying problems contributing to the gun violence crisis among South Sudanese young adults.

Ranada, R. T. (2024) This study investigates the impact of a comprehensive mentorship program on the motivation of associate degree radiologic technology students to pursue a baccalaureate degree. Among growing concerns over the educational advancement gap in radiologic technology, this study emphasizes mentorship as a pivotal factor in enhancing students' motivation toward higher education. Conducted at a Community College in Southern California, the intervention targeted a diverse group of 32 students, employing a mix of workshops and one-on-one mentoring sessions over a 30-day period. The program was designed to provide guidance, support, and information on the benefits and pathways to achieving a baccalaureate degree in imaging sciences. Pre- and post-intervention surveys, grounded in Expectancy Value Theory (EVT), assessed changes in students' motivation. Statistical analysis was performed using paired samples t-tests. The results demonstrated significant increases in motivation across all measured outcomes, underscoring the effectiveness of mentorship in encouraging academic progression. This study contributes to the existing literature by highlighting the role of mentorship in bridging the gap between associate and baccalaureate levels in radiologic technology education. While the findings are promising, they also prompt further investigation into the scalability and applicability of such mentorship programs across different contexts and disciplines. Limitations include potential selection bias and the challenge of generalizing results beyond the study’s specific setting. Despite these constraints, the research highlights the potential of mentorship as a valuable strategy in fostering educational advancement and professional growth in radiologic technology students, suggesting a model that could be replicated or adapted in a similar educational environment.

Rao, S. (2024). Objective: The purpose of this doctoral scholarly project was to use evidence-based strategies to improve the perceived usefulness of the benefits of creating an individualized support network for caregivers for children undergoing treatment for cancer and to improve their engagement with a contemporary digital peer support tool where they could build their support network to seek help. The rationale for the study was the Unified Theory of Acceptance and Use of Technology (UTAUT) framework model, which explains a user’s intention to use a digital system and provides insight into usage behavior.
Methods: Caregivers of children undergoing cancer treatment were enrolled through advertising the study in a forum of a large childhood cancer coalition. Enrolled participants expected to use the digital peer support tool for a week after attending an initial on-boarding. Data was collected pre-study/poststudy survey tool, and the participant responses were captured using a 4-point Likert scale. Surveys were conducted using SurveyMonkey and additionally, tool usage patterns were recorded within the peer support tool platform. Microsoft Excel was used to tabulate the data and perform the analysis.
Results: Five participants enrolled in the study and completed the pre-study survey, three received onboarding, and only two completed the post-study survey. All participants who enrolled unambiguously agreed that the support of family and friends was important to them, and that they felt comfortable seeking support. Out of the two participants who took the post-study survey, one found the tool favorable to seeking help and support, and the other did not. Both participants used the tool minimally.
Conclusion: The study was hindered by low enrollment and response rates, making it difficult to draw any meaningful conclusions about the participants' perceptions of using the intervention to seek support. As a future recommendation, it is suggested to conduct the study in a more controlled environment, such as a local support group, where both the mentor(s) and members are familiar with the digital support tool. This should be done for a longer duration, ideally six to nine weeks, to generate more robust data.

Richards, M. K. (2024). Stigma surrounding mental health is a major barrier for college students to seek help. This project aimed to reduce perceived mental health stigma among nursing and occupational therapy assistant (OTA) students at a health sciences university through the Make It OK campaign. Utilizing a pre-post design with the Stigma-9 (STIG-9) questionnaire, the intervention involved implementation of a two-week campus-wide educational campaign to reduce stigma of mental illness. The campaign was delivered using a multimedia approach including, email, posters, and videos to reduce mental health stigma. A two-sample t-test and descriptive statistics were used to analyze changes in pre- (N = 51) and post-questionnaire (N = 18) responses. There was not a statistically significant difference between pre (M = 13.49, SD = 4.55) and post-questionnaire (M = 13.5, SD = 4.15) scores for perceived mental health stigma; t(33) = 2.03, p = .99. Variations in responses highlighted the complexity of changing beliefs, with some improvements, such as reduced perceptions of danger, and mixed outcomes, such as increased agreement that mental illness is a sign of personal weakness. The project demonstrated the potential for raising awareness and initiating attitude shifts, laying a foundation for ongoing efforts. Key recommendations include extending the campaign duration, incorporating interactive elements, and tailoring interventions to diverse cultural and demographic contexts. The administration plans to implement the Make It OK campaign annually to foster a supportive campus culture, enhance mental health literacy, and promote help-seeking behaviors. Future projects should address limitations such as survey fatigue and participant engagement to provide more definitive evidence on the effectiveness of stigma reduction initiatives.

Sorensen, K. (2024). Mental Health has become an issue for faculty on college campuses for some time now. There needs to be strategies put in place to help faculty cope with mental health, awareness, and confidence in using resources that are available. The purpose of this project was to implement an evidence-based wellness challenge to improve the perceived mental health, confidence level, and awareness of utilizing campus mental health resources among faculty at a Midwestern Community College, over three weeks. Faculty (N = 254) were invited to participate in the project by completing a pre-survey, three-week intervention, and a post-survey. Faculty who expressed interest (N = 8) were provided detailed instructions to complete a pre-survey, along with the three-week challenge options for utilizing the Health Advocate wellness technology platform Be Balanced resources. The intervention expectation was to interact with Health Advocate Be Balanced webinars, workshops, challenges, videos or articles, of the participants’ choice, at least two times a week for the three-week challenge period. The post-survey was sent via email to all faculty who had expressed interest in the project the day after the three-week challenge period. Faculty completed the pre survey (N = 6) and post-survey (N = 4) through Qualtrics. Due to the sample size, descriptive statistics were used to analyze the pre- and post-survey results. All outcomes of perceived mental health including stress, anxiety, and depression, confidence level, and awareness of utilizing campus mental health resources improved.

Yates, J. (2024). Problem: The disproportionate impact of maternal morbidity and mortality among Black women in the United States underscores concerns regarding the equity and effectiveness of maternal healthcare provision. This gap in maternal outcomes emphasizes the healthcare system's inadequacy in addressing the unique needs of diverse populations, necessitating dedicated efforts to rectify existing disparities.
Intervention: A video intervention conducted over a seven-week period aimed to address these disparities through increasing participants’ education, self-advocacy, and patient engagement. The initial two weeks involved participant recruitment, consent acquisition, and completion of a preintervention survey. Subsequent weeks focused on participants' interaction with educational content, post-intervention survey completion, data collection, and analysis.
Measures: A pre- and post-intervention online survey design was employed to measure the impact of the intervention on education, self-advocacy, and patient engagement. The pre-intervention survey comprised 11 questions, with the first two assessing participants' maternal health encounter frequency and comfort level in navigating maternal needs. Questions 3 to 11, categorized into education, self-advocacy, and engagement, utilized a 4-point Likert rating scale. The postintervention survey included the same questions, alongside two additional questions asking participants to evaluate the intervention’s efficacy.

Young, C. (2024). Problem: The most crucial rural health challenge is access to mental health care services. One Midwestern state is currently performing the worst is the U.S. for mental health care access. The purpose of this evidence-based project was to determine if completing thirteen e-learning behavioral health education integration modules would improve primary-care providers’ comfort level in managing and stabilizing patients with mental and behavior problems on various medications.
Intervention: Participants were asked to participate in 13 online educational modules that trained and educated in multiple facets of behavioral health integration (BHI). Measures: Pre- and post-intervention surveys using 35 questions, assessed on 5-point Likert scale answers the providers comfort level with managing patients with mental and behavioral problems on various medications and stabilizing them.
Results: 12 of 14 (86%) providers consented, fully completing pre- and post-surveys. Analysis showed significant increases in providers comfort levels for: total survey scores pre- (Mdn = 113) and post-intervention (Mdn = 123.5), Wilcoxon signed rank test (WSRT) p = 003; management-based scores pre- (Mdn = 60) and post-intervention (Mdn = 60), WSRT p = 036; disease-based scores pre- (Mdn = 47.5) and post-intervention (Mdn = 52.5), WSRT p = 005; and integrated care scores pre- (Mdn = 8) and post-intervention (Mdn = 9), WSRT p = 003.
Conclusions: There are gaps in primary care providers comfort levels managing and stabilizing patients with mental and behavioral problems that can be improved with appropriate BHI training. Prior to BHI and collaborative care clinic initiatives being commenced, we recommend primary care providers receive appropriate BHI training.