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Characteristics of the Clinical Learning Environment in Basic Skills Courses in Traditional Baccalaureate Nursing Programs: a Qualitative Study
No full textElectronic Thesis or DissertationClinical education is a standard teaching practice in nursing education curricula for traditional baccalaureate nursing programs across the United States. As a practice discipline, integrating clinical education into the nursing curriculum is essential for students' transition into practice. Many nursing students experience their first clinical encounter in their basic skills course early in their educational journey, yet little is known about how the clinical environment affects learning. The challenge facing nurse educators is the lack of evidence supporting the design of clinical learning experiences. However, to establish best practices, it is important to comprehend the current clinical practices in successful programs across the United States. This qualitative study aimed to better understand the characteristics of the clinical learning environment for basic skills nursing courses in traditional baccalaureate nursing programs in selected southeastern states that achieved a 90% or greater first-time pass rate on the NCLEXRN in 2021. Nine clinical nurse educators participated in the study. Data were collected through semi-structured interviews and analyzed using thematic analysis. Lave and Wenger's Situated Learning Theory served as the framework for the study. The defining characteristics of the clinical learning environment in top-performing programs included realistic, structured, and scaffolded environments; a community of practice that can adapt to new roles and is invested in student success; and engaging pedagogical practices that help students form connections and immerse themselves in the nursing role. This study is significant for nursing education as it offers insights into the characteristics of the complex learning environment. Nurse educators and nursing practice partners can use these findings to reflect on and improve the clinical learning environment in their basic skills courses
In Twitter We Trust: a Study of Young Voters' Trust in Election Misinformation on Twitter
No full textElectronic Thesis or DissertationMisinformation runs rampant online. Social media websites have wrestled with the responsibility of spreading this misinformation, and some sites have responded by marking misinformation to attempt to stop the spread. As the world continues to change, there is a growing need to understand how young people interact with social media and the trust that they have in news on social media. This study seeks to understand this relationship by utilizing an experimental design that shows a tweet that contains election misinformation and asks participants to report their level of trust in the information's accuracy. Participants are shown the same tweet, either tweeted from a random Twitter user, President Trump, CNN, or Fox News. This study finds that traditional news media still hold credibility in young voters' minds and that ideology significantly impacts a person's trust
Enhancing Patient Care: Nurse-Initiated Ultrasound-Guided Intravenous Access
No full textDNP ProjectIntroduction/Purpose: Difficult intravenous access (DIVA) presents a challenge to hospitalized patients and healthcare providers. When peripheral intravenous catheter (PIVC) access attempts fail, central venous access devices (CVADs) are used. Nurses can identify DIVA and insert PIVCs using ultrasound early in hospitalization. This project trained nurses to perform intravenous access with ultrasound through brief education and simulation-based learning.
Methods: Study participants were recruited from the obstetrical unit at the project site. After consent, they completed an online module and practiced ultrasound-guided PIVC insertion with simulators. Competence was assessed using simulations, and changes in confidence and IV success rates were compared before and after the intervention.
Results: Eighteen registered nurses participated in the intervention. The level of confidence in PIVC insertion demonstrated a significant improvement from pre-intervention (M = 41.61, SD = 9.568) to the post-intervention (M = 48.28, SD = 3.578). All participants achieved competency during simulated placements of ultrasound-guided PIVCs. PIVC attempts decreased post-intervention (M = 1.5 vs. 1.8), but the difference was not statistically significant, p = .259. Consults for ultrasound-guided PIVC insertion by VAT or CRNA decreased from 5 to 2 across the study period.
Discussion: Applying ultrasound to guide intravenous access for DIVA patients provides better outcomes for patients and reduces stress on providers. Abbreviated training programs that include didactic principles, simulation-based learning, and proctored application are sufficient to educate nurses in providing this skill
Index to The Consequences of Confederate Citizenship: The Civil War Correspondence of Alabama’s Pickens Family
No full textThis is an index created by Dr. George C. Rable for research
Healthcare in Alabama’s Black Belt: Impacts of Potential Medicaid Cuts
No full textThe evidence from expansion states demonstrates that Medicaid expansion is not only beneficial for public health but also economically advantageous. For the Black Belt, where healthcare disparities are most acute, expansion could be transformative, increasing access to care, creating jobs, preventing hospital closures, and injecting much-needed resources into struggling rural economies.
As Alabama continues to navigate healthcare policy decisions, the impact on its most vulnerable communities must be a primary consideration. The health of the Black Belt reflects the health of Alabama as a whole, and investments in equitable healthcare access today will yield dividends in improved health outcomes, economic vitality, and quality of life for generations to come.College of Education’s Rising Tide Grant Progra
Decolonizing the Wilderness: Indigenous Representation in U.S. National Parks
No full textElectronic Thesis or DissertationFor millions of Indigenous Americans, National Parks can serve as a reminder of centuries of American policy designed to eradicate Indigenous people and culture. To overcome a legacy built on violence, National Parks have worked hard to increase collaboration with Indigenous peoples and provide visitors with more opportunities within park spaces to learn about and interact with Indigeneity. Challenges still exist for the park service, as park spaces can often fail to provide Indigenous peoples with agency over their own stories. Instead, many parks favor colonial retellings of history, which minimize contemporary Indigenous connections to the land. Thus, this thesis investigates how National Parks have, in many cases, successfully improved Indigenous interpretations in park spaces while still, in some cases, providing visitors with antiquated information that devalues the contemporary significance of Indigenous people and cultures. For interpretive staff throughout the National Park Service, antiquated Indigenous interpretations represent shortcomings rooted in outdated federal policy. National Park Service staff work hard to make parks accessible and inclusive for all visitors, but colonial legacies still permeate these spaces, negatively affecting the visitor experience. By engaging in participatory critical rhetorics and visiting each of the thirteen National Parks included in this thesis—paired with racial rhetorical criticism of three case studies—this thesis explores how National Park spaces either provide or deny visitors opportunities to learn about Indigenous people and cultures throughout their park visit. Specifically, this thesis seeks to understand how National Parks motivate visitors to more meaningfully engage with Indigenous ways of knowing, challenging the contemporary legacies of colonialism. For the National Park Service, this analysis provides valuable insight into the successes of interpretation in various National Park spaces while also highlighting areas where interpretation does not communicate to visitors the contemporary importance of Indigenous people and cultures. Ultimately, this analysis contributes to a growing body of work both inside and outside of communication studies, dedicated to the interrogation of colonial power dynamics and the impacts of these relationships on our contemporary structures
Clean Burning Wood Combustor Using Rich Quench Lean
No full textElectronic Thesis or DissertationHuman and environmental impacts of harmful emissions produced from combustion processes have received increased awareness in recent years. The need to find viable solutions to emissions issues has led to much research to understand how these emissions are formed and how to reduce them. Carbon free and renewable fuels are other alternatives options being explored at present. However, renewable fuels are also prone to emissions of soot, smoke, or particulate matter (PM), nitric oxides (NOx), and carbon monoxides (CO) that must be controlled in the combustion process. This study focuses on renewable biomass fuels used in residential wood burning furnaces, biomass gasifiers, industrial biomass furnaces, etc. The objective of this study is to develop a clean burning residential wood burning combustor. Currently, the Environmental Protection Agency (EPA) requires PM emissions from residential wood heaters to remain within 2.5 g/hr, and further reductions are projected to take place in coming years. Wood combustion also produces harmful emissions of CO and NOx, and although these emissions are not regulated at present for wood burning furnaces, future designs of wood burning furnaces must reduce all types of combustion emissions. This study introduces the concept of Rich Quench Lean (RQL) combustion to reduce emissions in residential wood burning furnaces. In RQL combustion, wood is gasified at rich conditions in the primary zone, gasified products are mixed with additional air in the quench zone, and finally, lean premixed mixture is burnt in the secondary combustion zone. This thesis includes a discussion of how different types of fuels affect gasification in the primary zone, and then, presents multiple designs of secondary zone that successively result in cleaner burning flames. Details of the experimental setup and test results are provided to illustrate the RQL approach and its potential to significantly reduce all types of emissions in residential wood burning furnaces
Latin American Migrants: Narratives on Affect and Displacement Through the Spanish Speaking World and Beyond
No full textElectronic Thesis or DissertationThis dissertation examines the figure of the migrant, and the experience of migration captured in a variety of formats (novels, testimonies, autobiographies) produced by Peruvian, Chilean, Colombian, Venezuelan, Argentine, Cuban, Mexican, and Honduran creators, since the beginning of the latest stage of globalization in the late 20th century. Drawing on the insights of anthropology and affect theory, I analyze the emergence of new subjectivities characterized by duality and rootlessness, how societies create the Other and produce locations where to place him, and how affects shape individuals’ behavior when responding to challenges and devising survival strategies. In my research, I show how migration starts far before leaving a country and the degree to which it extends beyond the crossing of national borders since this action represents, at best, just the first of multiple barriers people must face and, in some cases, the only one they manage to cross. Esta disertacion examina la figura del migrante y la experiencia migratoria plasmada en diversos formatos (novelas, testimonios, autobiografías) producidos por creadores peruanos, chilenos, colombianos, venezolanos, argentinos, cubanos, mexicanos y hondureños desde el inicio de la última etapa de la globalización a finales del siglo XX. Con base en la antropología y la teoría del afecto, analizo el surgimiento de nuevas subjetividades caracterizadas por la dualidad y el desarraigo, cómo las sociedades crean al Otro y generan espacios donde ubicarlo, y cómo los afectos moldean el comportamiento de los individuos al responder a los desafíos y diseñar estrategias de supervivencia. Esta investigación muestra cómo la migración comienza mucho antes de salir de un país y hasta qué punto se extiende más allá del cruce de fronteras nacionales, ya que esta acción representa, en el mejor de los casos, solo la primera de las múltiples barreras que las personas deben enfrentar y, en algunos casos, la única que logran superar
Empowering Futures: Expanding Educational Opportunities in Alabama's Black Belt
No full textIssue Brief No. 6
Integrating Ultrasound-Guided Peripheral Intravenous Access to Improve First-Time Attempt Success: Quality Improvement Initiative
No full textDNP ProjectBackground: Peripheral intravenous (PIV) access is a critical intervention in healthcare, yet traditional methods often result in multiple attempts, increasing risks of infection, patient discomfort, and healthcare costs, especially in patients with difficult IV access (DIVA). Findings consistently demonstrate that ultrasound guided peripheral intravenous access (USGPIV) improves first-attempt success rates, ranging from 55% to 90%, while reducing complications, patient discomfort, and procedural delays. Studies also highlight increased patient satisfaction and fewer insertion attempts with ultrasound guidance. Implementation challenges, such as training and resource allocation, are emphasized, particularly in high-demand settings like emergency departments and intensive care units. Successful integration of USGPIV access requires structured training programs and adequate resources in order to improve patient care quality and outcomes, optimize procedural efficiency, and enhance healthcare cost-effectiveness.
Methods: A pre- and post-intervention design was used to evaluate the impact of standardized USGPIV training among ICU charge nurses at two hospitals within a regional health system. The two-week intervention included didactic instruction, hands-on simulation, and competency validation led by the Vascular Access Team (VAT) and the facility’s ultrasound education coordinator. Data collection included pre/post Learning Self-Efficacy Scale (L-SES) surveys, direct observation, and organizational quality improvement (QI) metrics of first-attempt success rates. Descriptive and comparative analyses were performed.
Results: Post-intervention findings demonstrated significant improvements in nurse confidence, knowledge, and procedural skill. Mean post-test scores on key L-SES items increased by up to 2.5 points, with p-values ranging from 0.017 to 0.045 across multiple domains. Average first-attempt PIV success improved from 2–3 attempts using traditional methods to one attempt following USGPIV training, indicating both statistical and clinical significance.
Discussion: Implementation of a structured USGPIV training program enhanced nurse competency, increased first-attempt success rates, and optimized patient outcomes, aligning with national infusion therapy standards. These results validate ultrasound guidance as an effective, evidence-based approach for vascular access in critical care settings. Sustainability is supported through integration of USGPIV competency into ongoing training, policy revision, and mentorship by VAT educators