Digital Commons Network^™

Staff Education To Improve Hypertension Management Knowledge, Angelor Eliscard

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project, I addressed inconsistent staff knowledge of evidence-based strategies for preventing and controlling hypertension among African American women in an outpatient primary care setting. The practice-focused question was: In an outpatient clinical setting, what was the impact of an evidence-based staff education program on healthcare providers' knowledge of hypertension prevention and control strategies for African American women, as measured by pretest and posttest scores? The purpose of this project was to implement and evaluate a structured staff education program to improve providers' knowledge of evidence-based strategies for preventing and controlling hypertension …

Reducing Live Discharges Using A Tiered Protocol In A Rural Hospice: A Quality Improvement Project, Jemma Lowak

Doctor of Nursing Practice Final Project Abstract

Purpose: To reduce 30-day caregiver-driven hospice revocations by implementing a tiered post-admission nursing visit protocol based on caregiver preparedness. Background: Caregiver distress and inadequate support contribute to hospice revocations and interruptions in care. Increased nursing contact during the first week of enrollment may improve caregiver preparedness and reduce crisis-driven hospitalizations. Methodology: An eight-week quality improvement project using the Plan-Do-Study-Act framework was implemented at a rural hospice agency. Caregivers completed a Caregiver Preparedness Survey to assign preparedness tiers and guide additional nursing visits during the first week. Process measures included survey completion and protocol adherence. Outcome measures included caregiver preparedness and …

Improving Adherence To Remote Patient Monitoring (Rpm) For Patients With Hypertension, Chioma Udegbune

Student Scholarly Projects

Practice Problem: Hypertension is a leading contributor to cardiovascular disease, and suboptimal adherence to remote patient monitoring (RPM) limits opportunities for timely intervention and effective blood pressure management in outpatient primary care.

PICOT: The PICOT question that guided this project was: Among outpatient clinic nursing staff responsible for remote patient monitoring (RPM) in adults with hypertension (P), how does implementation of a structured nurse-led education and reminder protocol (I), compared to standard RPM practices consisting of routine onboarding and passive reminder processes (C), influence patient adherence to RPM protocols (O) over a 10-week period (T)?

Evidence: Evidence supports nurse-led education, …

Best-Practice Patient Education On Glp-1, Low-Glycemic Diet, Intermittent Fasting, And Exercise For Weight Loss In Obese Nondiabetics, Clara Green

Walden Dissertations and Doctoral Studies

Executive Summary: Clinical Practice Guideline Best-Practice Patient Education on GLP-1, Low-Glycemic Diet, Intermittent Fasting, and Exercise for Weight Loss in Obese Nondiabetics by Clara Green MS, Walden University, 2020 BS, University of Texas at El Paso, 2014 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2026

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Development Of A Clinical Practice Guideline For Hpv Vaccination In Low-Income Adolescents Using The Agree Ii Framework, Jariatu Fatu Bundu

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) vaccination is an effective strategy for preventing HPV-related cancers; however, vaccination initiation and series completion remain suboptimal among adolescents, particularly those from low-income and underserved populations. This Doctor of Nursing Practice project addressed an evidence-to-practice gap involving the absence of a standardized clinical practice guideline (CPG) for HPV vaccination in a family practice setting serving predominantly low-income adolescents. The purpose of the project was to develop and validate an evidence-based CPG to standardize provider recommendations and support improvement in HPV vaccination initiation and series completion. Evidence was appraised and synthesized using the Johns Hopkins Evidence-Based Practice Model, …

Stewardship In Action: Reducing Unnecessary Antimicrobial Use In Long-Term Care, Mariatu Sulaiman

Walden Dissertations and Doctoral Studies

Antimicrobial overuse in long-term care facilities (LTCFs) contributes to antimicrobial resistance, avoidable healthcare costs, and adverse drug events, particularly when antibiotics are prescribed for asymptomatic bacteriuria rather than symptomatic urinary tract infections (UTIs). Evidence-based clinical practice guidelines, including the McGeer Criteria, provide standardized approaches for differentiating true UTIs from asymptomatic bacteriuria and supporting appropriate antimicrobial prescribing. The purpose of this evidence-based practice project was to evaluate the development and implementation of a clinical practice guideline incorporating the McGeer Criteria into an antibiotic stewardship program in an LTCF. The practice-focused question examined what evidence supports strategies for reducing unnecessary antimicrobial use …

Nursing Staff’S Perception Of The Implementation Of The Obstetric Emergency Code Pink, Mareena Johnson

Walden Dissertations and Doctoral Studies

The local nursing practice problem addressed by this DNP doctoral project was the inconsistent and uneven response to obstetric emergencies within the health care setting. The purpose of this project was to evaluate the current implementation of the Code Pink protocol, identify any gaps or barriers in its effectiveness, and gather insights from nursing staff to propose refinements that would enhance its reliability and impact., The perception of nursing staff regarding obstetric emergency codes represents a critical dimension in the domain of maternal and neonatal health care, significantly influencing the efficacy of emergency responses and patient outcomes. Obstetric emergencies, such …

Shared Equity Leadership In An Offshore Medical School: Distributing Responsibility For Equity, Vishal B. Surender, Sreekrishna Penna, Oluwabusola Osimosu

Journal of Comparative & International Higher Education

This essay applies the Shared Equity Leadership (SEL) framework to an offshore MD program at a private Caribbean medical school where students complete basic sciences on an island and clinical clerkships across multiple international sites. Using SEL scholarship and de-identified institutional data, we ask how equity work is currently distributed, where gaps emerge in assessment, remediation, and mobility for historically underrepresented students in medicine, and how responsibility for equity might be more deliberately shared. The Woven model of SEL provides a lens to map existing structures like curriculum committees, CQI dashboards, advising systems, and clinical site partnerships. We propose a …

Home-Use Oct For Neovascular Age-Related Macular Degeneration: A Rapid Review, Sneh S. Shah

inSIGHT

Neovascular age-related macular degeneration (nAMD) requires frequent monitoring to identify recurrent exudation and guide treatment with anti-vascular endothelial growth factor (VEGF) therapy.1 Clinic-based optical coherence tomography (OCT) plays a central role in management but provides only intermittent assessments of a disease that changes over time. Home-use OCT technologies have recently been developed as a possible solution, allowing patients to perform self-imaging with remote clinician review and artificial intelligence (AI)-assisted analysis. This rapid review summarizes current evidence on home-use OCT for nAMD, including feasibility, diagnostic performance, clinical usefulness, and challenges related to implementation. Findings from feasibility studies, AI validation analyses, observational …

Implementing A Standardized Counting Process, Paula M. Mbye

Master's Projects and Capstones

Abstract

Background: In a Northern California medical center with 11 operating rooms, two retained foreign object (RFO) events occurred following surgical procedures in 2025.

Problem: Surgical teams rely on manual counting processes to prevent retained foreign objects. Variability in counting practices among registered nurses and surgical technologists, combined with workflow interruptions and environmental distractions, can increase the risk of counting discrepancies and missed items. Standardizing the counting process may improve count accuracy and reduce the risk of RFOs.

Interventions: This quality improvement project implemented a standardized surgical counting process based on Association of periOperative Registered Nurses (AORN) guidelines within …

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Improving Pain Reassessment Within One Hour Of Pain Medication Administration, Geraldine B. Macalma

Master's Projects and Capstones

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, …

Belonging And Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia Hickman

Papers

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

A Program Proposal For An Evidence-Based Dietary Program To Support Spanish Speaking Diabetic Patients, Shaquetta Ann Mccloud-Petion

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) executive leadership system improvement project addresses provider-identified gaps in dietary education for Spanish-speaking patients with diabetes, which may contribute to suboptimal glycemic control and diabetes self-management. A comprehensive review of evidence from CINAHL Complete, PubMed/MEDLINE, and Cochrane supports the use of culturally tailored, evidence-based dietary education to improve diabetes knowledge, self-management behaviors, and health outcomes. The project proposes the development and implementation of a standardized dietary education program using culturally appropriate dietary exchange tools within an outpatient clinic. The initiative aims to improve staff confidence, adoption, and consistency in delivering culturally responsive diabetes education …

Standardizing Interfacility Transfer In And Out Processes Across The Local Va Setting, Petrice Robinson Brown

Walden Dissertations and Doctoral Studies

The quality improvement project focused on the inconsistent documentation and communication of the transfer of veterans in and out of a Veterans Affairs Medical Center. Lack of transparency in handoff knowledge and ineffective documents posed a risk of delayed care and patient injuries. The staff provided an audit tool with staff education to monitor completion of mandatory transfer steps, such as special mode travel approval, equipment needs, nurse-to-nurse handoff, transfer notes, consent, and physician correspondence. This method was based on the evidence found in literature indicating that structured checklists and handoff tools minimize missed information and facilitate safer care transitions …

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Staff Education To Improve Staff Knowledge, Confidence, And Intent To Consistently Implement Medication-Assisted Treatment, Matilda Boachie

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed inconsistent medication-assisted treatment (MAT) implementation in a masked crisis stabilization unit. MAT was available, but staff education was informal and inconsistent, contributing to variation in knowledge, confidence, patient education, documentation, and discharge planning. The practice-focused question that was answered through this project was whether structured staff education would improve knowledge, confidence, and intent to consistently implement MAT. The purpose was to develop, implement, and evaluate structured education for interdisciplinary staff. De-identified pre- and post-education surveys were analyzed with descriptive statistics, and aggregate averages were compared because individual surveys were not matched. …

Staff Education To Improve C-Ssrs Suicide Risk Screening Competency, Pearl Binka

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed inconsistent administration and documentation of the Columbia-Suicide Severity Rating Scale (C-SSRS) in an acute care mental health setting. The practice problem was important because inconsistent standardized screening could delay identification of patients who required timely safety interventions. The practice-focused question examined whether structured C-SSRS education improved nursing staff competency, screening consistency, and documentation compliance. The project was developed and implemented to strengthen nurses’ knowledge, confidence, and skill in applying the C-SSRS as part of routine suicide risk screening. Evaluation strategies included comparisons of pre- and posteducation knowledge scores, competency checklist completion, chart audit findings, …

Staff Education Project To Increase Nursing Staff Knowledge Of Falls Prevention In Long-Term Care Facility, Oludele Olagoke

Walden Dissertations and Doctoral Studies

Falls among residents in long-term care facilities are a concern for families and facility management. Falls inflict pain, discomfort, and head trauma, causing fractures. In nursing practice, falls are nursing-sensitive indicators that reflect the quality of nursing care and patient safety. There is a need to bridge the gap and increase staff knowledge on how to prevent falls in the facility. The Doctor of Nursing Practice (DNP) project focused on increased nursing staff knowledge through an evidence-based education program and the implementation of an evidence-based practice education program. The DNP project practice question was about nursing staff in long-term care …

Staff Education On Psychoeducation Delivery To Enhance Medication-Adherence Education For Adults With Bipolar Disorder In An Outpatient Psychiatric Mental Health Facility, Bibiana Chinwe Ndula

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed inconsistent delivery of evidence-based medication-adherence psychoeducation for adults with bipolar disorder (BD) in an outpatient psychiatric mental health facility. The project question was whether an 8-week structured module, in relation to existing staff education practices, would increase staff knowledge and confidence. The intervention was guided by the Johns Hopkins evidence-based practice (JHEBP) model and comprised a PowerPoint presentation, a facilitator guide, a handout, a checklist, a toolkit, and anonymous pre- and post-training assessments. Eight out of ten invited staff completed the project. The mean knowledge rose from 6.1 to 8.9 …

Staff Education To Standardize Chronic Pain Patient Education In Primary Care, Jessica Okpara

Walden Dissertations and Doctoral Studies

Inconsistent delivery and documentation of chronic pain patient education may contribute to variations in patient knowledge, treatment expectations, and engagement in self-management. This Doctor of Nursing Practice staff education and quality improvement project was designed to standardize chronic pain patient education in a primary care setting. The practice-focused question examined whether implementing standardized chronic pain education, compared with non-standardized education, would improve patient knowledge and use of self-management strategies over 10 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model, the project included development of evidence-based education materials, staff preparation, workflow integration, and a standardized documentation process. Clinic staff identified …

Improving Glycemic Control And Self-Care Among Adult Patients With Type 2 Diabetes Mellitus At A Community Health Center, Lydia Asabea Lartey

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a significant practice concern in community health settings, where adults often encounter barriers to effective self-management, including low health literacy, socioeconomic challenges, and limited access to Diabetes Self-Management Education and Support (DSMES). At the project site, inconsistent staff preparation, high patient volume, and limited standardized teaching resources contributed to gaps between evidence-based standards and routine diabetes education. To address these gaps, the project implemented a standardized, culturally responsive diabetes-education workflow to strengthen care quality, patient safety, and responsible resource use. The practice question guiding the project was: How does implementing a standardized, culturally responsive …

Staff Education To Providers Prescribing Glp-1 Medications For The Treatment Of Obesity, Madeleine Williams

Walden Dissertations and Doctoral Studies

The utilization of glucagon-like peptide 1 (GLP-1) medications has skyrocketed over the past 5–8 years, with an average weight loss of 15–21% of initial weight. Unfortunately, not all providers offer evidence-based patient education when starting a GLP-1 medication for the treatment of obesity. A practice gap I have identified is the lack of consistent evidence-based education providers utilize when prescribing GLP-1 for obesity treatment in the primary care setting. The project site was a hospital-based primary care clinic located in a suburban community in Washington. This staff education aimed to evaluate whether a standardized, evidence-based educational tool on GLP-1 medications …

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …

10-Bed Medical-Surgical Telemetry Unit Expansion To Address Inadequate Inpatient Capacity, Sumitpal Kaur

Walden Dissertations and Doctoral Studies

Inadequate medical-surgical telemetry capacity contributes to emergency department (ED) boarding, patient transfers, decreased patient satisfaction, and operational inefficiencies. This systems-level organizational leadership project evaluated a proposed 10-bed medical-surgical telemetry unit expansion at a medical center in Northern California. The project addressed the question of how a 10-bed expansion would affect ED boarding, patient crossovers to a nearby medical center, patient satisfaction, and financial performance. Trend analysis of occupancy, ED boarding, and crossover data, regional benchmarking, and financial modeling using net present value (NPV) and internal rate of return (IRR) were used to evaluate the proposed expansion. The organization currently operates …

Staff Education To Reduce Stress In Assisted Living Nursing Staff, Cherechi Onyenso

Walden Dissertations and Doctoral Studies

In this staff education doctor of nursing practice (DNP) project, I addressed a practice gap associated with inadequate staff knowledge of workplace stress-management strategies in an assisted living facility. Workplace stress in nursing practice is a contributing factor to burnout, reduced job satisfaction, poor teamwork, and a decline in the quality of resident care. The practice-focused question for this project was about whether staff knowledge would be enhanced over an 8-week period in comparison to baseline knowledge as a result of their participation in a structured staff education program on workplace stress management. The purpose of the project was to …

Staff Education To Improve Knowledge And Confidence In A1c Screening For Adults With Serious Mental Illness, Veronica Akweley Odoi

Walden Dissertations and Doctoral Studies

This project was conducted to observe the effects of staff education on staff knowledge and confidence regarding metabolic risk and hemoglobin A1c (A1C) monitoring for adults with serious mental illness in a crisis response unit. The lack of a streamlined system in metabolic testing in recent times has led to nuances in metabolic testing for patients with serious mental illness. The practice-focused question asked whether evidence-based staff education on A1C monitoring, and provider roles would improve staff knowledge and confidence. The purpose of the education is to strengthen knowledge of metabolic risk, A1C screening expectations, role clarity, workflow, and staff …

Implementation Of A Nightshift Sleep Promotion Bundle To Support Delirium Prevention In A Neurosurgical Intensive Care Unit, Pamella Simpson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project aimed to identify the need for a consistent sleep-promotion protocol in an adult neurosurgical intensive care unit (NSICU). Disrupted sleep is a frequent problem for patients who are seriously ill and can lead to delirium, longer hospital stays, higher health care expenses, diminished cognitive function, and death. While there was evidence supporting nonpharmacological sleep-promotion and delirium-risk-reduction interventions, they were not consistently implemented at the project site, creating a gap between evidence and clinical practice. The purpose of this project was to implement and evaluate an evidence-based night-shift sleep-promotion bundle. The practice-focused …