D.N.P. - Nursing Practice

Permanent URI for this collectionhttps://hdl.handle.net/10125/36917

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Providing education on the Columbia-Suicide Severity Rating Scale (C-SSRS) for support workers at correctional facilities
(University of Hawai'i at Manoa, 2025) Boling, Jamie; Tse, Alice; Nursing
AbstractIncarcerated individuals, especially female inmates, are at a significantly higher risk of suicide compared to the general population, largely due to past traumas and the stress of incarceration. Factors such as childhood trauma, sexual assault, physical abuse, and substance abuse exacerbate these mental health challenges. This quality improvement project aims to enhance the ability of support workers at the Women’s Community Correctional Facility in Kailua to identify and intervene with inmates at risk of suicide, thereby reducing the incidence of suicide within the facility. An educational program focused on the Columbia-Suicide Severity Rating Scale (C-SSRS) was implemented to equip support workers with the skills necessary to recognize signs of suicidal ideation and take appropriate intervention measures. Preliminary findings indicate an increase in the support workers' confidence and competence in using the C-SSRS, leading to more timely and effective interventions. These results suggest that targeted educational programs may enhance the capacity of correctional facility support worker staff to address suicide risks among inmates. By improving identification and intervention processes, such programs may contribute to better mental health outcomes for incarcerated individuals, particularly women, who are disproportionately affected by past traumas and the stresses of incarceration. Further applications of evidence-based practice is recommended to explore the long-term impact of these interventions on suicide rates within correctional facilities. Keywords: Suicide prevention, C-SSRS, Correctional facility, support worker
Enhancing clinical instructor confidence: Evaluating the impact of a targeted training program on the use of clinical evaluation tool
(University of Hawai'i at Manoa, 2025) Clearwater, Ruthie; Mattheus, Deborah; Nursing
Clinical instructors are vital to bridging theoretical knowledge with real-world practice, and standardized tools like the Clinical Evaluation Tool (CET) ensure fairness and consistency in student assessments. However, many instructors face challenges due to inadequate preparation, resulting in variable and subjective evaluations. This project aims to improve nursing faculty’s confidence in using the CET through a four-week targeted training program. Grounded in theoretical frameworks such as Benner’s Novice to Expert Model and Adult Learning Theory, the project provides structured mentorship and training to enhance evaluative skills, standardize clinical assessments, and ultimately improve student outcomes. Pre- and post-training surveys, based on the Self-Efficacy for Clinical Teaching (SECT) model, will evaluate changes in instructor confidence. The project’s implications for nursing education emphasize the need for ongoing faculty development and mentorship, aligning with the DNP Essentials and advancing clinical education quality.
Improving communication and collaboration in a DNP program through the use of technology: Enhancing clinical resource accessibility through technology-based toolkit
(University of Hawai'i at Manoa, 2025) Teshima, Katie; Glauberman, Gary; Nursing Practice
Problem Statement: Doctor of Nursing Practice (DNP) students at University of Hawaii at Manoa School of Nursing and Dental Hygiene face challenges in accessing pertinent clinical resources efficiently. Implementation of an updated virtual clinical resource toolkit may better facilitate and improve student clinical care and competency.Purpose: Increase DNP student accessibility to clinical resources for informed decision-making during patient care. Methods: A pre-implementation survey was conducted to identify current needs, use patterns, and preferences regarding clinical resources. These findings were utilized to update an outdated list of resources and create a clinical resources toolkit, which was then reviewed and approved by current DNP faculty. The toolkit was distributed and made accessible through an online learning platform. After a period of one month, the toolkit’s ease of use, perceived usefulness, and behavioral intention to use were assessed through survey. Results: Participants (N=9) reported significant increases in self-reported confidence and ease of accessing clinical information. The majority found the toolkit highly useful for decision-making, with strong positive feedback on its relevance and organization. However, some students reported delayed utilization, highlighting a need for early integration. Conclusion: The clinical resources toolkit was well received, with results indicating its effectiveness in supporting DNP students’ clinical learning. Overwhelmingly positive feedback suggests that structured implementation within coursework may enhance adoption. Recommendations: Ongoing refinement, expansion, and course integration of the toolkit may improve DNP student resource accessibility for clinical practice.
Strategic marketing strategies to increase uptake and awareness of a start-up RTMS Academic Learning Clinic
(University of Hawai'i at Manoa, 2025) Akimoto, Joel; Nunokawa, Courtnee; Nursing
Problem Statement: Despite growth in the U.S. mental health sector and rising demand forrepetitive transcranial magnetic stimulation (rTMS), academic clinics in Hawaiʻi face competition, limited differentiation, and underutilized marketing, highlighting the need for strategic approaches to improve visibility, engagement, and access. Purpose: Evaluate the effectiveness of a strategic marketing plan in increasing awareness, utilization, and engagement for rTMS treatments at a new academic learning clinic serving individuals 16 years and older with treatment-resistant major depressive disorder (MDD) on Oʻahu. Methods: An evidence-based strategic marketing plan including branding, website optimization, direct marketing, referral process, and an open house event was implemented. Quantitative and qualitative data from focus groups, collaborative website design, and a post-event survey were analyzed using descriptive statistics and thematic analysis to assess impact on visibility, engagement, and utilization. Results: The CLEM Clinic launched a unified brand, SEO-optimized website template, and secure HelloSign referral form. Targeted emails increased survey response by 41.2%. The open house saw 89.9% attendance, with post-event survey data (n=17) showing high awareness (94.1%), clarity (94.1%), and marketing effectiveness (94.2%). Motivation and intent were positive but lower (85.3%), indicating a need for stronger messaging. Follow-up was moderate with 23.5% shared referrals, 41.2% requested additional information, and two expressed personal interest in rTMS. Discussion: The strategic marketing enhanced clinic visibility, stakeholder engagement, and initial behavioral intent. Key achievements included cohesive branding, digital infrastructure, and a secure referral system. Strong engagement emerged from direct marketing and the open house, with 96.8% affirming effectiveness and 94.1% reporting increased awareness. However, lower personal motivation suggests a need for more persuasive, personalized messaging. Strengths included evidence-based design, practical relevance, and interdisciplinary collaboration. Limitations such as a small sample size and limited generalizability indicate a need for further research on long-term impact and scalability in diverse healthcare settings.
Targeted case manager training for eating disorder oversight: Supporting informed care coordination
(University of Hawai'i at Manoa, 2025) Lopez Jaffe, Rosa Elena; Nunokawa, Courtnee; Nursing Practice
Timely coordination of specialty behavioral health services remains a critical challenge within integrated systems, particularly for individuals presenting with eating disorders (EDOs). Case managers (CMs) play a pivotal role in triaging and navigating these referrals, yet variability in knowledge and confidence contributes to delays, access issues, and care inequity. This quality improvement project implemented a targeted training intervention to improve CM understanding of EDO diagnostic criteria, comorbidities, levels-of-care, and treatment team roles.Pre- and post-training surveys measured self-reported knowledge and confidence across five domains: diagnostic recognition, level-of-care placement, system navigation, treatment teams, and culturally responsive practices. A dual Likert-scale format quantified cognitive uptake and self-efficacy. Descriptive statistics revealed consistent improvements, with mean scores increasing from a pre-training range of 2.8–3.4 to a post-training range of 3.8–4.4. Median and mode values shifted from 3 (neutral) to 4 (agree), indicating stronger consensus. Qualitative analysis of open-ended responses yielded themes of enhanced role clarity, improved system navigation, and the need for sustained support. CMs reported increased confidence in coordinating care across interdisciplinary systems and engaging complex systems. Pre-survey data showed that 25 of 37 CMs (67.6%) lacked formal EDO training and 35 of 37 (94.6%) were unprepared for care coordination, despite 30 of 37 (81.1%) having previously managed EDOs. Post-survey results showed marked improvement, with 30 of 33 (90.9%) reporting increased understanding and 28 of 33 (84.8%) expressing greater confidence. This project offers a scalable framework for workforce development, training redesign, and implications for organizational integration, and sustainability strategies are discussed.
The impact of gratitude interventions on depression and stress levels in Korean American adolescents
(University of Hawai'i at Manoa, 2025) Bang, Hanna; Mobley, Joseph; Nunokawa, Courtnee; Nursing
Problem Statement: Korean American (KA) adolescents encounter unique cultural and psychological challenges that heighten their vulnerability to depression and stress. Although there is increasing recognition of these risks, culturally tailored interventions addressing their specific mental health needs remain limited. Gratitude-based interventions have demonstrated effectiveness in improving psychological outcomes; however, their applicability and impact among KA adolescents remain underexplored. This study aims to examine the effectiveness of daily gratitude practices on depression, stress, and gratitude levels among KA adolescents, with the goal of informing culturally sensitive strategies to enhance adolescent mental health. Purpose: This study aims to evaluate the effectiveness of daily gratitude interventions in reducing depression and stress levels among Korean American (KA) adolescents. Findings will offer evidence-based insights into the therapeutic benefits of gratitude practices, informing the development of culturally tailored mental health strategies to support this underserved population. Methods: A single-group pretest-posttest design was employed involving Korean American (KA) adolescents aged 12 to 18. Participants completed a daily gratitude journaling intervention over a one-week period, during which they recorded three things they were grateful for each day and composed one gratitude letter. Levels of depression, stress, and gratitude were assessed using validated psychological instruments administered both before and after the intervention. Results: The study included 15 Korean American adolescents with a mean age of 14.9 years. Following the gratitude intervention, participants demonstrated statistically significant reductions in depression and perceived stress, as well as increased levels of gratitude. Conclusion: The results demonstrate that daily gratitude journaling and gratitude letter writing intervention may serve as effective therapeutic complements in reducing depression and stress levels while enhancing positive emotions among Korean adolescents. These findings highlight the value of culturally tailored gratitude-based practices in promoting adolescent mental health and emotional well-being.
Nursing peer review in a rural hospital labor and delivery unit: Implementation of a holistic peer-to-peer feedback process
(University of Hawai'i at Manoa, 2025) Lung, Christina; Mattheus, Deborah; Nursing Practice
Problem Statement: The SCORE (Safety, Culture, Operational risk, Resilience/burnout and Engagement) survey is launched by a four-hospital healthcare system to routinely measure coworker perspectives on leadership, burnout, safety climate, teamwork, and improvement readiness. Individual department data from the survey demonstrated that nurses in the Family Birthing Unit are hesitant to speak up, discuss errors, and learn from others. In another staff survey, nurses from this unit scored low on trust amongst teammates. There is no formal process for peer-to-peer feedback in this unit. Purpose: The purpose of this project was to develop, implement, and evaluate a comprehensive nursing peer review process to increase nurse perception of teamwork, communication and overall culture of safety. Methods: Nurses in the unit were educated about nursing peer review and randomly assigned to pairs. Using a peer review form, the nurses evaluated the nursing practice of their peer in a face-to-face conversation, sharing examples both of how their peer excels and areas of opportunities. Pre and post peer review surveys were done to measure peer interactions. Results: After one round of peer review, nurse perception of how they are treated by their peers, having trusting relationships, and their working environment was rated more positively. Discussion: Some nurses did report the random pairing process didn’t match them with someone they worked with often, making the process more difficult. However, by practicing peer to peer feedback using a structured approach, overall teamwork and safety climate can be improved. Peer review should be a routine practice, integrated into the culture for optimal outcomes.
Evaluating the effectiveness of first aid and naloxone training in school settings: An evidence-based approach
(University of Hawai'i at Manoa, 2025) Leonhard, Lindsey; Mobley, Joseph; Nursing Practice
Problem Statement: Opioid overdoses are a growing concern in many communities, and the lack of trained personnel in school settings to respond to such emergencies is a significant gap in addressing this issue. Naloxone, a life-saving medication for opioid overdoses, along with first aid training, is essential for improving the response to these incidents in schools.Purpose: This project aimed to evaluate the effectiveness of naloxone and first aid training in HIDOE school settings, focusing on enhancing knowledge, confidence, and readiness to respond to opioid overdose and other medical emergencies. Methods: A pre- survey was administered to 21 participants, including registered nurses and advanced practice registered nurses, who had completed the naloxone and first aid training. The survey assessed participants' comfort, knowledge, and confidence levels related to naloxone administration and first aid. A post-training survey, completed by 42 participants, was also conducted to assess the changes made in these areas. Quantitative and qualitative data were collected, analyzed using Microsoft Excel for descriptive statistics, and thematically analyzed for open-ended responses. Results: The pre-survey results indicated high levels of comfort and confidence in administering naloxone and first aid, with participants reporting improved knowledge and readiness to intervene in overdose situations. The post-survey results demonstrated further improvement, with 59.5% of participants feeling “extremely confident” in their ability to respond to an opioid overdose and 52.4% feeling “extremely prepared” to train others. Discussion: The findings align with the literature on the importance of hands-on, scenario-based training for improving healthcare professionals' response readiness. The project underscores the need for continuous updates to training materials, addressing logistical challenges, and offering hybrid learning options to enhance training accessibility and effectiveness. The data from both pre- and post-training surveys confirm that the naloxone and first aid training program significantly enhanced participants' preparedness to respond to opioid-related emergencies and train others in similar settings. Keywords: Naloxone Training, First Aid Training, School Settings, Overdose Prevention, Healthcare Education, Evidence-based Practice
Evidence-based review for anxiety screening of school-aged children with autism spectrum disorder
(University of Hawai'i at Manoa, 2025) Ring, Harmony Delight; Mattheus, Deborah; Nursing
Currently, there is no guidance on screening tools for anxiety in children aged 6-12 with autism spectrum disorder (ASD). The United States Preventive Services Task Force (USPSTF) and the American Academy of Child and Adolescent Psychiatry (AACAP) recommend screening children for anxiety. However, screening tools for pediatric anxiety do not account for different manifestations of anxiety in pediatric patients with ASD. The purpose of this project is to conduct a literature review on the available screening tools for pediatric anxiety to determine the ideal screening tool for children with ASD and to incorporate these findings into a training module for nurses and practitioners in the Hawaii Keiki (HK) Healthy and Ready to Learn Program. The Spence Children’s Anxiety Scale (SCAS) was identified as the most ideal screening tool for anxiety in school-aged children with ASD, and an education module was successfully developed and implemented. The results indicate that not only can an education module be implemented at HK as the best practice for new and existing staff on a regular basis which can assist in increasing healthcare professionals’ understanding and comfort of regularly screening as appropriate. Implications of this study were also discussed, particularly in their application in practice. The results of this project provide preliminary evidence to support the notion that an education module can increase healthcare professionals’ comfort with using the SCAS to screen for anxiety in children with autism spectrum disorder.
Managing stress in higher education: Does participation in adult soccer leagues decrease stress scores of college students pre to post-season?
(University of Hawai'i at Manoa, 2025) Barnes, Jaymie; Mobley, Joseph; Nursing Practice
This Doctorate of Nursing Practice evidence-based practice project on managing stress in an academic setting was prompted due to an increasing number of college students unable to control their stress and well-being effectively. Centered on numerous studies indicating that individuals who engage in regular physical activity have lower levels of anxiety, depression, and stress, this project’s objective was to evaluate stress management by comparing stress levels of college students who participated in the adult leagues of the Hawaii Soccer Association (HSA) and American Youth Soccer Organization (AYSO), pre-and post-season, during the Fall academic semester. The project site was completed online through email. Stress was measured pre- and post-intervention using the Perceived Stress Scale (PSS). A Google Form was also used to collect demographic information and data about academics and sports.
Enhancing trainer confidence and comfort: Evaluating the impact of evidence-based follow-up support in the Hawaiʻi keiki train-the-trainer program
(University of Hawai'i at Manoa, 2025) Le, Aime; Mobley, Joseph; Nursing
Problem Statement: The opioid epidemic in the United States has significantly impacted adolescent populations, with fentanyl-related overdoses on the rise. In Hawai‘i, this crisis has led to legislative measures supporting overdose education and naloxone distribution in public schools. The Hawai‘i Keiki Train-the-Trainer (TTT) program equips school staff with lifesaving overdose response skills. However, the program lacks continued support for trainers, potentially affecting their confidence and effectiveness in delivering training.Purpose: This quality improvement project aims to enhance the Hawai‘i Keiki TTT program by implementing a follow-up session 28 days after the initial training. The objective is to assess whether this additional support improves trainers' confidence and comfort in delivering first aid and naloxone training to Hawai‘i Department of Education (HIDOE) staff. Methods: A pre-post survey design was used to evaluate the impact of the follow-up session. Participants included Hawai‘i Keiki registered nurses (RNs), advanced practice registered nurses (APRNs), and health technicians. Surveys assessing self-reported confidence and comfort levels were administered before training, immediately after training, and after the follow-up session. Results: The follow-up intervention further reinforced confidence and comfort levels across all domains. Mean scores for the ability to respond appropriately to an opioid overdose rose from 3.55 post-training to 3.65 post-follow-up. Mean scores for explaining how to use naloxone nasal spray to HIDOE staff rose from 3.52 to 3.74, and overall preparedness to train others on opioid overdose prevention and naloxone administration increased from 3.40 to 3.70. Open-ended responses highlighted the value of interactive discussions, knowledge exchange, and scenario-based learning during the follow-up session. Trainers appreciated the clarity and usability of the training materials and requested additional follow-up support, including mentorship opportunities. Trainers noted that delivering more training would increase their confidence. Discussion: The study suggests the effectiveness of incorporating a follow-up session into the Hawai‘i Keiki TTT program. Reinforcement through the follow-up session enhanced trainers’ confidence and comfort levels in delivering first aid and naloxone training, beyond what was achieved through the initial training alone.
Implementing a stress management training for DNP students to improve stress management, stress reduction, and mindfulness awareness
(University of Hawai'i at Manoa, 2025) Langi, Louis Leveni; Mobley, Joseph; Nursing Practice
Background: The absence of a standard stress management training program may result in poor knowledge of stress management, increased stress levels, and higher chances of burnout among graduate nursing students.Purpose/Aim: The purpose of this DNP project was to evaluate whether DNP students’ participation in a stress management training would result in a reduction of stress level, improvement in mindfulness awareness, and increased knowledge of management of stress over the course of an academic semester. Methods: This project implemented an online-based stress management training for second-year DNP students at the University of Hawai’i at Manoa, focused on mindfulness-based stress reduction. Utilizing a single-group pretest posttest study design, the project assessed students’ perceived stress level and mindfulness attention awareness as well as students’ perspective of knowledge of stress management. Results: Analysis of pre- and post-intervention data revealed a possible increase in mean scores of students’ perceived stress scores and a possible decrease in mean scores of students’ mindfulness attention awareness scores. However, mode and median scores of students’ perceived stress scores possibly decreased, while students’ perceptions of knowledge of stress management possibly improved. Conclusion: The project demonstrates the effectiveness of stress management training in improving students’ knowledge of stress management and its applicability if incorporated into a DNP curriculum. It provided students with the knowledge and education to better manage stress in the academic and healthcare field. Implications/Recommendations: Future efforts in incorporating stress management training in the academic DNP curriculum can help provide DNP students with the knowledge and education to better handle stress early on to help reduce future burnouts.
Developing a resource of adolescent sexual and reproductive health clinics for school nurse practitioners
(University of Hawai'i at Manoa, 2025) Pak, Jenna; Mattheus, Deborah; Nursing Practice
Background/significance: School nurse practitioners can play a vital role in improving adolescents’ access to sexual and reproductive health education. Purpose/Aim: The purpose of this project was to create an online resource of sexual and reproductive health clinics within the communities on the Big Island, Maui, Kauaʻi, Lanaʻi, and Molokaʻi to be utilized by nurse practitioners located in school clinics. The project aims to improve the knowledge, intention, and perceived ability of nurse practitioners in making referrals for sexual health clinics. Methods: This project implemented an educational intervention for school nurse practitioners in the Big Island, Maui, Kauaʻi, Lānaʻi, and Molokaʻi. A pre-post test design was utilized to assess the knowledge, attitude changes, and perceived ability among school nurse practitioners before and immediately after the intervention. Nurse practitioners received an online in-service training and have continuous access to a guide of adolescent-friendly referral clinics for students on each island. Pre and post surveys were completed to measure the knowledge, confidence, and comfort of school nurse practitioners in providing reproductive and sexual health referrals. Results/Outcomes: The analysis of the pre and post intervention data showed improvements. The participants showed increased confidence towards providing sexual health referrals. There was an improvement in the participants’ perceived ability to make community referrals and having the necessary resources to do so. There was also a small increase in the knowledge of nurse practitioners. Conclusion: This project indicated that an intervention can increase a provider’s ability and confidence to facilitate referrals to sexual health clinics for adolescents. The findings from the project indicate there can be a significant impact from interventions that promote access to sexual and reproductive health resources to adolescents. Implications/Recommendations: Future projects can focus on the various barriers that exist for sexual and reproductive health care and resources for adolescents.
Pediatric anxiety screening in a school-based setting
(University of Hawai'i at Manoa, 2025) Shih, Zoe L.; Mattheus, Deborah; Nursing
Anxiety is one of the leading childhood mental health disorders and often goes undiagnosed. School based clinics play an important role in being able to screen students for anxiety and provide referrals if needed. Nurses working for Hawaii Keiki (HK): Healthy and Ready to Learn need guidance on what tool to use for screening elementary aged children. A literature review and analysis were conducted and a comprehensive list of commonly used anxiety screening tools utilized in the school setting was collected. The Spence Children’s Anxiety Scale (SCAS) was the most highly utilized and ideal for use by HK nurses as it is free and publicly available, has over 30 translations, and can be completed in under 10 minutes. It was recommended that HK utilize the SCAS in its elementary school clinics to screen students suspected of having anxiety. An evidence-based practice implementation project was performed to train HK nurses on anxiety and how to use the SCAS. A survey was given prior to the training to collect baseline knowledge and then the same survey was given after the training to determine the amount of knowledge gained from the training. Analysis of the survey data indicated that this implementation project was effective in educating the staff about anxiety and the appropriateness of the SCAS for the elementary school setting.
Evaluating the effectiveness of the Hawaii keiki naloxone training program: A quality improvement initiative
(University of Hawai'i at Manoa, 2025) Higuchi, Carolyn; Mobley, Joseph; Nursing Practice
Background: School-based interventions play a vital role in addressing the opioid crisis. The Hawai‘i Keiki program, a partnership between the University of Hawai‘i and the Department of Education, provides naloxone and CPR training to DOE staff as part of a nurse-led initiative to strengthen overdose response in schools.Purpose: This quality improvement project evaluated the effectiveness of the Hawai‘i Keiki Naloxone Training Program by assessing trainer confidence, identifying areas for improvement, and aligning with national best practices. Methods: Using the Iowa Model, the project involved a literature review, a comparison of national programs, a pre-training needs assessment, training updates, a post-training follow-up session, and a post-survey evaluation. Descriptive and inferential statistics were applied to Likert-scale data, and qualitative feedback was gathered during follow-up. Results: Post-survey data (n=23) showed statistically significant increases in trainer confidence across all domains (p < 0.001), with comfort scores improving by +1.1 to +1.3 points. Trainers reported greater readiness to respond to overdoses and deliver training. Qualitative feedback highlighted improved clarity, resource access, and the value of peer discussion. The program aligned with national standards, with strengths in accessibility, nurse-led delivery, and school integration. Conclusion: The Hawai‘i Keiki Naloxone Training Program effectively enhanced trainer preparedness. Continued development such as tracking naloxone use, offering follow-up sessions, and providing refresher training will support long-term impact and model excellence in school-based overdose response.
Managing stress in academic settings: Evaluating the impact of a mindfulness app on perceived stress levels in doctor of nursing practice students
(University of Hawai'i at Manoa, 2025) Egan, Rayson-Lee; Mobley, Joseph; Nursing
In the demanding landscape of higher education, stress has become an increasingly more prevalent challenge for graduate students, particularly those enrolled in programs such as the University of Hawaii at Mānoa School of Nursing and Dental Hygeine, Doctor of Nursing Practice (DNP) program. This doctoral study investigates the impact of a comprehensive mindfulness intervention on the well-being of graduate students in the DNP program at the University of Hawaii at Manoa (UHM). Based around the acknowledgment of stress as a complex issue that is influenced by various individual, social, and environmental factors, the study aims to address the effects of unmanaged stress on students' mental health. This study, through an analysis of the existing research and theoretical frameworks, proposes that the mobile mindfulness application, Headspace, can be used as a practical and accessible tool to help manage stress. The intervention is a nonrandomized controlled clinical trial in design and provides participants with full access to the Headspace app over a 7-day period. This study uses a validated, quantitative tool: the Perceived Stress Scale (PSS), to assess changes in stress levels and overall well-being before and after the intervention. Qualitative feedback will also be gathered to evaluate the feasibility and acceptance of the mindfulness app among DNP students. The results of this study implicate the need for improving the accessibility and diversity of the support systems available for graduate nursing students, with the ultimate goal of exploring new ways to support their mental health.
Development of school-based referral system for sexual health services
(University of Hawai'i at Manoa, 2025) Watanabe, Nami; Mattheus, Deborah; Nursing
Background/significance: Adolescents are particularly vulnerable to negative sexual health outcomes. Despite this, many adolescents avoid seeking sexual and reproductive health services for various reasons, including concerns about confidentiality, limited access, and lack of awareness. Purpose/Aim: This project aimed to create a referral list that can serve as the primary tool for school nurses at Hawaiʻi Keiki to guide the selection of an appropriate service provider to facilitate making a referral in the community. Timely access to sexual health services is crucial in enhancing adolescents’ sexual health outcomes. Methods: A referral guide was developed using the implementation framework developed by Project Connect. An in-service meeting was held to familiarize school nurses with using this toolkit effectively. After the referral guide was disseminated, school nurses completed both the pre-survey and the post-survey to examine whether the intervention helped to improve their confidence and knowledge in linking students to youth-friendly providers in the community for sexual and reproductive health services. Results: This quality improvement looked at constructs that influence an individual’s behavior derived from the Theory of Planned Behavior. Overall, an upward trend was observed across all domains when comparing the mean scores at the pre- and post-intervention levels. Conclusion: School nurses are in an ideal position to establish a trusting relationship with students, often becoming their trusted figures and advocates. Given the sensitive nature of sexual and reproductive health, school nurses can serve as a trusted point of contact for students who might otherwise feel uncomfortable to seek help.
Improving communication and collaboration in a DNP program through the use of technology: Enhancing student and faculty experience through technology-based clinical evaluations
(University of Hawai'i at Manoa, 2025) Pali, Jenina Joyce Pascua; Glauberman, Gary; Nursing Practice
Problem Statement: Submitting clinical evaluation forms has relied upon hard copy paper forms, resulting in inefficiencies in completing these important documents, and causing delays in submissions. A technology-based solution to address this issue may contribute to decreased time expended on this process for both students and faculty, and overcome some of the most frequently encountered challenges related to timely submission of paper evaluation forms. Purpose: The purpose of this project was to develop a streamlined process for submitting clinical evaluations on the UH Kuali Build platform. Methods: The UH Kuali Build evaluation forms were developed and piloted with eligible participants. A pre-questionnaire survey and a post-questionnaire survey were designed to evaluate the effectiveness and user-friendliness of the platform. Results: A total of 35 participants volunteered to participate. The mean difference in scores from pre-implementation to post-implementation Likert-type questions increased by 2.01, 1.66, 1.74, 1.9, 2.3, and 2.26 from questions one to six, respectively. The mode increased from 2 in the pre-implementation questions to 5 in the post-implementation questions. The mean and mode increases indicate that the Kuali Build forms improve user workflow and are recommended over the current paper-based forms. Qualitative data revealed that, on average, participants took one minute to complete the Kuali Build evaluation forms, compared to 10 minutes for the current paper-based evaluation forms. Discussion Results indicate that the Kuai Build forms enhance participants’ workflow and efficiency during the clinical evaluation submission process. Overall results suggest that users accept and are more willing to utilize the Kuali Build evaluation forms compared to the current paper-based evaluation forms. The project demonstrated how technology can be applied to improve the efficiency of the clinical evaluation process, ultimately saving time and effort for both DNP students and faculty.
Improving communication and collaboration in a DNP program through the use of technology: Gamifying prospective student engagement for DNP program recruitment
(University of Hawai'i at Manoa, 2025) Simms, Joan Christel Marcial; Glauberman, Gary; Nursing
AbstractBackground/Significance: Gamification enhances engagement in virtual learning but requires careful consideration of content complexity, pacing, and technical factors. While gamification has improved classroom interaction, current Doctor of Nursing Practice (DNP) online informational sessions lack these strategies, leading to suboptimal engagement and missed recruitment opportunities. Purpose: This project aimed to enhance engagement in online DNP informational sessions by incorporating gamification through integration of Kahoot! activities. Methods: A 10-question Kahoot! activity was developed with faculty guidance and integrated into two virtual informational sessions in November 2024 and January 2025. Engagement was assessed via participation rates, answer accuracy, and post-session evaluations measuring responding, valuing, satisfaction, and perceived usefulness. Results: Across both sessions, 22 participants engaged in the Kahoot! activity during two DNP informational sessions. Session One had full participation (100%), while Session Two had 69% engagement, with response rates of 56% and 53%, respectively. Participants primarily valued clinical practice and skill development, with the Family Nurse Practitioner track being the most popular. Quiz performance improved in Session Two, with a correct answer rate of 54.55% compared to 18.18% in Session One. Overall, evaluation of the Kahoot! activities indicated strong participant satisfaction and engagement, though perceived usefulness slightly decreased in Session Two. Conclusions: Gamification appears to enhance engagement in virtual DNP sessions. Optimizing content pacing and ensuring technical reliability are key to sustaining participation. Implications/Recommendations: Future initiatives should refine content delivery, incorporate follow-up strategies, and expand gamification applications in academic and professional settings.
Improving communication and student engagement in a DNP program through the use of technology: Increasing DNP student knowledge and awareness about course evaluations
(University of Hawai'i at Manoa, 2025) Gregory, Emma; Glauberman, Gary; Nursing Practice
Problem Statement: Doctor of Nursing Practice (DNP) student course evaluation completion at the University of Hawai’i School of Nursing and Dental Hygiene is consistently below the targeted rate. This poses a challenge to implement program changes based on the students’ experience. Improving students’ understanding of course evaluations may boost participation. Purpose: The purpose of this evidence-based practice project was to determine if implementing an educational intervention delivered using technology could increase students’ intention to complete course evaluations. Methods: The intervention consisted of a digital infographic curated to address common questions about course evaluations. The infographic was distributed to DNP students via email with a five-minute contextual video. A pre- and post-survey were given to students to assess knowledge and awareness about course evaluations. Results: A total of 8 DNP students participated in the intervention. The average student Likert scale rating increased from pre- to post-survey for the following four questions: DNP Curriculum and Program Development Committee utilizes course evaluations for program updates, the DNP program reviews course evaluations, evaluations are a valuable use of time, and other students complete course evaluations. A question assessing if students intended to complete the course evaluation saw no change in average rating, and a question regarding course evaluation anonymity saw a decrease in average rating. Discussion: The increase in average Likert scores for knowledge-related survey questions suggests a positive shift in students’ understanding of course evaluations. However, the relatively small change in intention-related survey scores indicates that awareness alone may not be sufficient to drive participation. Incentives, alternative feedback methods, and faculty reinforcement of the evaluation’s significance may be necessary to improve completion rates.

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