Depression Screening in the Adult Inpatient Oncology Population

Routinely screening oncology patients for depression is recommended due to the higher rates of depression in this population as well as the negative impact of untreated depression. The goal of this QI project is to implement a standard depression screening protocol for patients admitted to this hospital, where there is currently no standard screening protocol. There were 110 patients included in this study, and 67 (60.91%) of patients received a PHQ-9 screening. Of the patients who completed the PHQ-9, 21 (19.09%) had a positive screening, which was a score of seven or higher. While there were high rates of provider notification (n = 18, 85.71%) and moderate rates of social work notification (n = 12, 59.09%) when patients screened positive, rates of treatment initiated were lower (n = 6, 27.27%). Having the EMR prompt nurses to perform PHQ-9 screenings and prompt providers when patients have a positive screening may increase the rate of patient treatment. Improving access to mental health treatment for oncology patients is important for the health of this population, and this project represents an important step in the right direction

The Write Time for an Autoethnography: How Writing Project Has Shaped My Understanding of Professional Learning in Community

This study critically examines the cultural and societal phenomenon that comprises the National Writing Project (NWP), specifically reflecting on my experiences of re-designing Gateway Writing Project professional learning experiences as a leader in the organization. I reflect on my encounters, collaborations, and decisions as an Institute instructor and analyze them within the theoretical framework of Communities of Practice using autoethnography as my research methodology. This autoethnographic narrative documents my analysis and understanding of NWP’s framework of social practices, chronicling my journey from participant to advocate and from organizer to leader. Employing the autoethnographic method enabled me to illuminate my own personal and professional growth that has come from continued engagement in social learning practices, leading me to a call of action for educators to find, create, and sustain their own professional learning communities

What Factors Impact Teachers’ Beliefs about the Likelihood to Which Their Students with Intellectual and Developmental Disabilities Can Live on Campus

After the Higher Education Opportunity Act was passed in 2008, inclusive postsecondary programs for students with intellectual disability (ID) have grown on campuses across the United States. These programs were designed to eliminate barriers that prevent students with intellectual disability from attending college in order to achieve positive employment outcomes and skills to increase independent living. While programs may be designed for those with intellectual disability, individuals may have multiple diagnoses, including intellectual and developmental disabilities (IDD). The relationship between a student and their secondary teachers can positively impact their future or present a barrier. Using the data from the Higher Education Needs Assessment Survey, which examines the views of special education teachers on inclusive postsecondary programs, this study aims to examine the relationship between specific perceptions of special educators and on-campus housing for students with ID. This study can shed light on the professional development needs of educators

Reimagining Discipline: Elementary School Counselors’ Experiences Implementing and Advocating for Restorative Practices as an Alternative to Exclusionary Discipline

School counselors are positioned as leaders and advocates within their school communities, playing a critical role in promoting equitable practices and systemic change. Despite decades of research indicating the harmful effects of exclusionary discipline, this approach continues to be implemented in schools across the United States. Emerging literature has indicated restorative practices as an alternative discipline approach that promotes equity, reduces disproportionality in school discipline, and fosters a positive school climate. This research focused on the experience of elementary school counselors advocating for and implementing restorative practices as an alternative to exclusionary discipline. Through a hermeneutic phenomenological and social constructivist framework, 11 elementary school counselors engaged in semi-structured interviews sharing their unique experiences in advocating for and implementing restorative practices. Thematic analysis yielded three overarching themes: (1) Elementary School Counselor Readiness to Implement Restorative Practices, (2) The Elementary School Counselor’s Critical Role in Implementing Restorative Practices: Navigating Barriers Through Action and Advocacy, and (3) The Benefits of Restorative Practices Speak for Themselves. Findings of this study contribute to scholarship by identifying elementary school counselors as leaders in the implementation and advocacy of restorative practices, providing critical context for their role in promoting equitable discipline practices. Implications of this study provide valuable strategies and techniques for school counselors to effectively advocate for and implement restorative practices within their school communities, as well as, for counselor educators training future school counselors

Beyond Thanks for Your Service : Navigating the Challenges of Memorializing the Global War on Terrorism

As objects of public commemoration, the American public expects our national war and veteran memorials to draw coherent narratives from diverse, often contradictory, experiences. In return, our society bestows these places with extraordinary authority, allowing them to define the essence of events from years ago. This dissertation explores that phenomenon in the context of the national Global War on Terrorism (GWOT) Memorial, which has been approved for placement in the National Mall and is in its design phase. As its framework, this dissertation uses the four truth framework developed by the South African Truth and Reconciliation Commission. With a focus on the GWOT and the current memorial plans, this framework examines the narratives emanating from a place or era using multiple truthful lenses to determine the similarities, differences, areas of agreement, and contestations. With data generated through on-site observation of visitors at existing war and veteran memorials, semi-structured interviews with key staff and GWOT veterans, and a review of the memorial literature, the research examines how current memorials have (or have not) included new narratives and evolving understandings of their subjects and how those insights might be applied to the GWOT Memorial. This dissertation then combines two styles of written product to share implications for site design and programming at the pending GWOT Memorial. The findings, which in this dissertation format are accessible to scholars, practitioners, and lay readers, suggest that for the GWOT Memorial to fully achieve its goals, it must be deliberately designed with a capacity to enable shared reflection, honor multiple perspectives and stories, and acknowledge new insights over time

Faculty Newsletter Fall 2025

https://irl.umsl.edu/libpub/1064/thumbnail.jp

Moonstorm in the Mainstream or on the Margins?: Constellating St. Louis Lesbian Rhetorics from the Archives

Combining rhetorical analysis, oral history collection, and archival study, this multi-genre research project explores lesbian feminist organizing in the 1970s. Moonstorm was a St. Louis lesbian feminist magazine that operated in the 1970s and 1980s. The sample in this research project focuses on the issues of Moonstorm published between 1973 and 1977. Issues of Moonstorm are available for viewing in the archives of the State Historical Society of Missouri. Building on V. Jo Hsu’s theory of constellating, the poems and stories found in Moonstorm serve as sites of both contested and unconditional belonging for modern LGBTQ+ activists. Constellating, specifically in the context of cultural rhetorics, maps the similarities and differences of rhetoric stored in the archives, allowing for a multiplicity of experiences to exist in unison. Collectivity, separatism, and feminist intersectionality are the primary topics of analysis in Moonstorm. Personal narrative and poems from the researcher constellate with the experiences found in Moonstorm and the oral histories collected for this project. The project also underscores the ways in which publics and counterpublics operate in the rhetorical sphere within the context of social justice movements

Electronic-Based Determinants of Health Screening on an Inpatient Behavioral Health Unit

Problem: Approximately 14.1 million Americans are diagnosed with a Serious Mental Illness (SMI). These individuals experience death 10-20 years earlier compared to the general population, primarily due to chronic medical comorbidities and unmet health-related social needs (HRSNs). Mortality rates, increased healthcare utilization, and frequent readmissions in patients with multiple, unmet HRSNs are likely to remain high unless developments such as the incorporation of standardized, multi-domain, social determinants of health (SDOH) screenings into electronic health records (EHRs). The purpose of this quality improvement (QI) project, guided by the Institute for Healthcare (IHI) model for change utilizing the Plan-Do-Study-Act (PDSA) cycle, was to evaluate the effectiveness of implementing a multi-domain, EHR-based, SDOH screening tool on its ability to comprehensively identify and address unmet HRSNs of adult patients with SMI and its impact on readmission rates. Methods: EHR-based, validated screening tools that assessed food insecurity and housing instability were administered to adults ages 18-75 years old, admitted to the inpatient Behavioral Health Unit (BHU), with a diagnosis or history of SMI. This study utilized a descriptive, observational design with a pre-and post-intervention approach to assess the frequency of psychiatric readmissions. Data was analyzed using a Wilcoxon Signed Rank Test, binary logistic regression, and descriptive statistics. Results: There were (N=119) patients who met the inclusion criteria. There were (n=34, 28.6%) patients who screened positive, with (n=24,20.2%) for housing instability, (n=22,18.5%) for food insecurity, and (n=12,10.1%) for both food and housing instability. The frequency of readmissions did not show a statistical difference (p = .291). The readmission rate was 10.9%, while 89.1% did not experience readmission. The readmission rate of 10.9% (n=13) correlates with the results of housing instability, which has higher odds of readmissions. The results revealed a statistically significant coefficient for endorsing housing instability (β=3.65), with an associated z-value = 13.2, p \u3c .001. Implications for Practice: Utilization of standardized screening tools integrated into the EHR can be beneficial for identifying food insecurity and housing instability in patients with SMI admitted to an inpatient psychiatric unit

Implementation of a Nurse-Driven Process to Decrease NPO Times in a Geriatric Emergency Department

Prolonged nil per os (NPO) status for geriatric patients in the emergency department is a critical safety issue, leading to increased rates of delirium, hypoglycemia, and perioperative complications. A quality improvement project was designed to address this problem through a targeted, nurse-driven intervention. In geriatric patients (age ≥70) in a geriatric emergency department, this project aimed to determine if implementing an electronic health record (EHR)-prompted nursing workflow to obtain a diet order would reduce the length of time patients were kept NPO compared with standard practice. An EHR documentation tool was designed and implemented along with targeted nursing education sessions at a large Northeastern hospital. A prospective chart review was conducted over a four-week post-implementation period. Outcomes included the time from provider assignment to diet order and the rate of missed diet orders. Data were analyzed using Interrupted Time Series Analysis (ITSA) for time-based outcomes and Chi-square analysis for categorical data. Nurses utilized the new workflow for 294 patients, representing a 37.9% adoption rate. The intervention resulted in a statistically significant immediate reduction of 65.5 minutes in the time from provider assignment to diet order (p = .002, 95% CI [−106.06, −24.95]). Furthermore, missed diet orders decreased significantly by 6.2% (p = .001, 95% CI [37.3%, 44.4%]). The implementation of a nurse-driven, EHR-prompted workflow successfully reduced prolonged NPO status and missed diet orders in a clinically meaningful way. This evidence-based project demonstrates that nurse-led, technology-supported interventions can significantly improve the safety and quality of nutritional management for geriatric patients in the emergency setting

Transportation: A Barrier to Healthcare Access Among Disabled, Older Adults with Diabetes and Hypertension in Rural Areas

Problem: Transportation is essential for health service utilization (clinic appointments, diagnostic services, and picking up medications from the pharmacy (Hansmann & Razon, 2024). Shekelle et al. (2022) in their systematic review and meta-analysis indicated that the U.S. rural population is 60 million. Rural areas continue to experience transportation as a significant barrier to health, a key social determinant of health. It causes delayed or foregone care in approximately 3.6 million people annually, resulting in more than 25% of missed appointments. Methods: This quality improvement project utilized a descriptive and observational design. A convenience sample of Medicaid patients receiving care at Mercy Family Clinic in Wright City was identified, and qualitative data were collected during the implementation period. The data collected included the patients’ age group, the number of times non-emergency medical transportation (NEMT) was offered, the distance from home to the clinic, the number of emergency room (ER) visits, and the diagnoses. Results: With the implementation of the quality project, thirty-two Medicaid patients were seen and reminded of the availability of NEMT. Of those, three missed their appointments, 9.3% (n=3). Implications for Practice: Interventions aimed at closing the transportation gap in rural areas are crucial for improving the health outcomes of this population by reducing the number of missed appointments