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Implementation Of A Standardized Protocol To Improve Provider Documentation And Initiation Of Guideline-Concordant Hypertension Follow-Up Within 14 Days In Primary Care, Stella Williams

Doctor of Nursing Practice Projects

Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality, yet timely follow-up after elevated blood pressure (BP) readings is not consistently documented in primary care. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether a standardized hypertension screening follow-up protocol improved provider initiation or documentation of guideline-concordant follow-up within 14 days. The faculty-approved PICOT population was primary care providers in a primary care clinic; we used eligible electronic health record (EHR) encounters as the analytic records to observe provider performance. We used a quantitative pre/post design and retrospectively reviewed 30 eligible EHR encounters: 15 pre-implementation …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

The Impact Of Evidence-Based Benzodiazepine Tapering Guidelines In An Outpatient Psychiatric Setting: A Quality Improvement Project, Addeh Tosin

Doctor of Nursing Practice Projects

Long-term benzodiazepine use is associated with dependence, withdrawal, cognitive impairment, falls, and overdose, yet tapering practices remain inconsistent in outpatient psychiatric care. This quality improvement project examined whether evidence-based deprescribing education improved psychiatric mental health nurse practitioners' (PMHNPs) self-efficacy, adherence to benzodiazepine tapering guidelines, and active prescription outcomes. The Plan-Do-Study-Act cycle guided implementation, the ADKAR Model guided change, Bandura’s Self-Efficacy Theory provided the theoretical framework, and the Stetler Model supported evidence translation. The project employed a quantitative, quasi-experimental, single-group pretest-posttest design and involved three PMHNPs from one outpatient psychiatric practice. Participants received one 20-minute educational session based on American Society …

Improving Provider Confidence In Suicide-Risk Screening Through Training On A Safe-T-Guided Pathway At Intake, Shukairo Mack Baker

Doctor of Nursing Practice Projects

Evidence supports structured suicide-prevention education, but inconsistent pathway use at outpatient intake prompted this quality improvement project to evaluate provider confidence. The aim was increased confidence after training on a Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) guided pathway. Donabedian's structure, process, and outcome model and the Awareness, Desire, Knowledge, Ability, and Reinforcement change model guided implementation through one Plan, Do, Study, Act cycle. A single-group pre-test and post-test design involved seven clinicians at one hybrid outpatient behavioral health clinic. All available eligible staff (100%) completed a 2.5-hour training and both surveys. The Suicide Risk Assessment Confidence Scale was administered …

Quality Improvement Project: Improving Nurse Confidence In Managing Patient Aggression Using The Brøset Violence Checklist And Team-Based Strategies, Grace Amakulor

Doctor of Nursing Practice Projects

Workplace violence remains a concern in psychiatric nursing, particularly when changes in patient behavior are not recognized early or communicated consistently. This quality improvement (QI) project was conducted at a psychiatric recovery center in Central Ohio after identifying a practice gap in aggression risk assessment and response. The purpose was to implement and evaluate a multicomponent aggression-management approach using the Brøset Violence Checklist (BVC), structured team huddles, and individualized aggression care plans. The aim was to improve nurse confidence (primary outcome) and reduce aggressive behavioral incidents (secondary outcome) over four weeks. Bandura’s Social Cognitive Theory and Lewin’s Change Theory guided …

Quality Improvement Project: Telehealth Follow-Up After Psychiatric Hospital Discharge, Ikemi Echeng

Doctor of Nursing Practice Projects

The period following psychiatric hospitalization is a high-risk transition during which inconsistent communication, delayed follow-up, and poorly coordinated referrals can create gaps in continuity of care. This quality improvement project addressed inconsistent post-discharge follow-up processes in a community outpatient mental health clinic. The purpose was to implement staff education and a structured workflow incorporating the Agency for Healthcare Research and Quality Discharge Phone Call Tool to improve staff confidence, telehealth follow-up, and referral coordination over eight weeks. A quantitative, quasi-experimental, one-group pre- and post-intervention design was used. Staff confidence was measured with Grundy’s C-Scale, and telehealth follow-up and referral activities …

Quality Improvement Project: The Impact Of Provider Education On Antipsychotic Medication Side Effects, Anthony Emego

Doctor of Nursing Practice Projects

Weight gain is a frequent and clinically relevant side effect of antipsychotic medication. A needs assessment at the project site found that roughly 55% of patients on an antipsychotic treatment had clinically significant weight gain, and providers had no formal training on how to prevent and manage this. The purpose of this quality improvement project was to determine if a provider-focused educational intervention is effective in increasing provider confidence and decreasing antipsychotic-induced weight gain in adult psychiatric patients. This quantitative, one-group pre-post design utilized Lewin's Change Theory and Bandura's Social Cognitive Theory. It was conducted at an outpatient psychiatric clinic …

Quality Improvement Project: Improve Patient Show Rate For Appointments At The Outpatient Diabetic Clinic, Smitha Mathew

Doctor of Nursing Practice Projects

Missed appointments disrupt diabetes management, delay treatment, and waste healthcare resources. This quality improvement project evaluated whether patient-centered scheduling, staff education, and multimodal communication reduced no-show rates among adults with diabetes. The Plan-Do-Study-Act model provided the theoretical and implementation framework, while Kotter’s Eight-Step Change Model guided practice change. The uncontrolled preintervention-postintervention project occurred from January through July 2026 in a hospital-based outpatient diabetes clinic. The evidence-based intervention included 45-minute staff education, scheduling based on patients’ preferred days and times, verifying contact information and communication preferences, sending telephone and text reminders, and re-engaging patients the same day after missed appointments. Appointment …

The Impact Of Provider Education On Medication Adherence In An Outpatient Psychiatric Clinic: A Quality Improvement Project, Tina Ezeh

Doctor of Nursing Practice Projects

Medication adherence is important in psychiatric care, as nonadherence can contribute to poor health outcomes and increased use of healthcare services. A needs assessment at an outpatient psychiatric clinic identified inconsistent medication adherence education, with only 30% of providers routinely providing education and 20% using a structured approach. The purpose of this quality improvement project was to evaluate structured provider education, with the aim of assessing changes in provider confidence and the frequency of medication adherence education over eight weeks. Kotter’s 8-Step Change Model guided project implementation, while the Donabedian Model was used for project evaluation. A quantitative, one-group pretest-posttest …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …

Quality Improvement Project: Early Screening For Kidney Disease In Primary Care Clinics, Binsy Easow

Doctor of Nursing Practice Projects

Chronic kidney disease (CKD) is a common complication of diabetes. Evidence-based guidelines recommend urine albumin-to-creatinine ratio (UACR) screening for early identification of albuminuria in patients with diabetes; however, screening was inconsistently completed in an outpatient primary care clinic. This quality improvement project evaluated the impact of a standardized, provider-focused intervention on UACR screening completion and therapy intensification in patients with microalbuminuria. The Iowa Model served as the evidence-based practice framework, Lewin’s Change Theory provided the theoretical framework for practice change, and the Plan-Do-Study-Act cycle guided implementation and evaluation. A quasi-experimental pre- and post-intervention design was used. The intervention was delivered …

Enhancing Healthcare Provider Confidence And Accuracy In Performing And Documenting The Abnormal Involuntary Movement Scale, Victoria Okoani-Nneji

Doctor of Nursing Practice Projects

Monitoring for medication-related movement disorders is essential for adults with schizophrenia receiving antipsychotic medications; however, inconsistent Abnormal Involuntary Movement Scale (AIMS) assessment and documentation can limit timely recognition of abnormal movements. This quality improvement project evaluated a six-week structured AIMS education program designed to improve provider confidence and documentation accuracy in an outpatient behavioral health setting in Central Ohio. Guided by Benner’s Novice-to-Expert Model and Kotter’s Eight-Step Change Model, the project used a one-group pretest-posttest design with 15 licensed behavioral health providers. Weekly sessions included instruction, demonstration, guided practice, case-based learning, scoring, interpretation, and electronic health record (EHR) documentation. Descriptive …

Quality Improvement Project: Determining Impact Of Mental Health Screening Provider Training, Sherri Bennett

Doctor of Nursing Practice Projects

Obesity is frequently associated with mental health concerns, yet these conditions may remain under identified when mental health screening is not consistently incorporated into medical weight-loss care. At the project site, fewer than 2% of patients who are overweight or obese were identified as needing mental health services, demonstrating a practice gap in screening and referral. The purpose of this quality improvement project was to evaluate whether targeted mental health screening education improved provider confidence. The aim was to increase confidence in conducting mental health screening among nurse practitioners in a medical weight-loss program. The Stetler Model provided the theoretical …

Quality Improvement Project: Improving Nurse Discharge Competency Through Standardized Education And Discharge Tools In An Inpatient Behavioral Health Hospital, Valina Williams

Doctor of Nursing Practice Projects

Inconsistent discharge education and variable use of structured discharge tools can affect the consistency of transitions from inpatient behavioral health care. The purpose of this Doctor of Nursing Practice quality improvement project was to improve nurse discharge competency by implementing standardized discharge education and reinforcing use of a structured discharge tool in a rural inpatient behavioral health hospital. A quantitative, quasi-experimental one-group pretest-posttest design was used over 12 weeks with 16 eligible registered and licensed practical nurses. Organizational readiness was assessed at baseline, and nurse self-efficacy was measured before and after implementation. Discharge-tool adherence and 30-day readmissions were also evaluated. …

Quality Improvement Project: Implementing The 2025 Aha Hypertension Guidelines In Rural Primary Care, Johanna M. Alvarez

Doctor of Nursing Practice Projects

Hypertension contributes to cardiovascular morbidity and mortality, and delayed adoption of updated guidelines can increase therapeutic inertia in rural primary care. This Doctor of Nursing Practice quality improvement project addressed an evidence-to-practice gap at a rural Federally Qualified Health Center where clinicians used 2017 American Heart Association/American College of Cardiology hypertension protocols after release of the 2025 guideline. The purpose was to determine whether structured education and point-of-care visual decision aids improved provider knowledge, attitudes, self-reported practices, and selected clinical adherence metrics over 3 months. Guided by the Iowa Model, Lewin’s Change Management Model, and the Plan-Do-Study-Act framework, a quasi-experimental …

Impacting Provider Knowledge, Attitude, And Practice Care In Adult Autism Spectrum Disorder Through Targeted Educational Interventions, Aganaba Alabi Anike Grace

Doctor of Nursing Practice Projects

Autism spectrum disorder is often considered a pediatric problem. However, undiagnosed autism among adults causes disproportionate healthcare inequities. Conventional ASD research and clinical training focus on pediatric groups, resulting in underdeveloped adult-oriented care and inadequately prepared providers. The project site reported discrepancies in ASD documentation and lack of knowledge in adult autism. The purpose of this project was to evaluate the impact of targeted educational interventions on provider knowledge, attitude, and practice of adult autism. The Iowa Model guided the translation of evidence into practice, whereas Kotter’s eight-step change model guided implementation. A quasi-experimental pretest-posttest design was used among 30 …

Staff Education To Improve 7-Day Post-Discharge Psychiatric Follow-Up, Michael Curtis Kwashie

Walden Dissertations and Doctoral Studies

Too many psychiatric patients leave the hospital without a follow-up appointment, a gap that may cost lives. Research has consistently shown that the days immediately after discharge from psychiatric inpatient or emergency care are among the most dangerous in a patient’s trajectory, marked by elevated suicide risk, relapse, and avoidable readmission. Yet, across behavioral health settings, completion of outpatient follow-up within 7 days of discharge remains inconsistent; typically, standardized processes are often missing. This doctoral project in staff education was created to fill that gap and examined whether implementing a standardized discharge transition protocol, supported by targeted, interdisciplinary staff education, …

Quality Improvement Project: Improving Nursing Knowledge And Confidence Of Dysglycemia In Pediatric Oncology Patients, Lindley Abrams

Doctor of Nursing Practice Projects

Treatment-induced dysglycemia is a frequently underrecognized complication of pediatric cancer therapy. Pediatric oncology nurses play a critical role in recognizing and managing dysglycemia; however, limited exposure to specialized dysglycemia education may contribute to gaps in knowledge and confidence. A site needs assessment found that 53% of nurses reported discomfort with glycemia-related concepts, supporting the need for targeted education. The purpose of the project was to evaluate changes in pediatric oncology nurses’ knowledge and confidence in recognizing and responding to treatment-induced dysglycemia. The project aimed to provide a structured educational intervention and measure pre- and post-intervention changes. Newman’s Health as Expanding …

Implementing An Evidence-Based Practice Training Program To Impact Nursing Skills Competency And Self-Efficacy In A Long-Term Care Facility, Angela Mcknight

Doctor of Nursing Practice Projects

Long-term care facilities require nursing staff who can competently perform clinical skills; however, the project site relied primarily on written in-service education and attendance verification without direct validation of psychomotor performance. The purpose of this quality improvement project was to evaluate competency-based nursing education in a long-term care facility. The aim was to strengthen demonstrated urinary catheterization competency and evaluate changes in perceived professional nursing competence and general self-efficacy among licensed nurses. A quasi-experimental, one-group pretest-posttest design included 12 registered and licensed practical nurses. Plan-Do-Study-Act guided implementation, Lewin’s Change Theory guided organizational change, and Social Cognitive Theory supported the educational …

Quality Improvement Project: Empowering Change: Evidence-Based Strategies To Improve Ai Use In Pedagogy, Amanda Boyle

Doctor of Nursing Practice Projects

Artificial intelligence (AI) continues to integrate into healthcare and higher education; however, Health Science faculty at the project site lacked formal training to operate or teach AI responsibly. This Doctor of Nursing Practice quality improvement project evaluated whether computer-based AI literacy education improved Health Science faculty members’ self-reported AI literacy. It was predicted that faculty AI literacy scores would improve after completing the intervention. Kotter’s change model and Benner’s novice-to-expert framework informed implementation of change and faculty professional development. The Plan–Do–Study–Act model supported evaluation. In a one-group, quasi-experimental preintervention–postintervention study design at a North Texas two-year college, 19 eligible Health …

Integrating Interprofessional Education To Strengthen Team-Based Mental Health Care, Adebisi Tijani

Doctor of Nursing Practice Projects

Fragmented interprofessional collaboration in outpatient mental health settings compromises care coordination and patient engagement. This quality improvement (QI) project implemented a structured interprofessional education (IPE) workshop series to improve team collaboration and reduce patient no-show rates in an outpatient mental health clinic. Guided by Bandura's Social Cognitive Theory and Lewin's Change Management Model, the project used a pre-post, single-group design with 12 licensed mental health professionals. The team measured collaboration with the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II) and collected aggregate patient no-show rates from the electronic health record. The intervention consisted of four monthly, one-hour workshops covering role …

Quality Improvement Project: Impacting Clinical Competency Through Faculty Preparation: A Standardized Teaching Guide Initiative, Caroline White

Doctor of Nursing Practice Projects

Variability in clinical teaching practices can contribute to inconsistent faculty preparation and student learning experiences. This quality improvement project addressed the absence of a standardized clinical teaching resource within an Associate Degree Nursing (ADN) program at a public technical college in the southeastern United States. The purpose was to implement a standardized, evidence-based clinical teaching guide to improve faculty confidence and clinical educator skill acquisition. Social Cognitive Theory provided the theoretical framework, and Lewin’s Change Theory guided practice change. A quantitative, quasi-experimental one-group pretest-posttest design was used. Fourteen eligible nursing faculty and clinical instructors were invited to participate; 10 participated, …

Standardized Screening And Monitoring Of Bioidentical Hormone Replacement Therapy In Women Ages 35–50, Amanda Ellen Hampton

Walden Dissertations and Doctoral Studies

In this quality improvement project, I evaluated a pilot implementation of a standardized bioidentical hormone replacement therapy (BHRT) screening and monitoring tool embedded within the electronic health record (EHR) at an integrative medicine practice in the southeastern United States. Grounded in the Johns Hopkins evidence based practice (EBP) model, the project addressed a documented gap in consistent screening, initiation, and monitoring of hormone replacement therapy (HRT) for women ages 35 to 50 presenting with menopausal symptoms. The practice focused question examined whether a standardized, EHR embedded BHRT screening and monitoring tool could improve screening rate compliance, laboratory monitoring adherence, and …

Mentorship As A Catalyst For Change Readiness: A Qualitative Study Of How Effective Mentoring Mitigates Burnout And Turnover During Organizational Transformation, Jeffery M. Camp

Journal of Online Mentoring

This qualitative study examined how effective mentorship mitigates burnout and attenuates turnover intention during organizational change, foregrounding the perspectives of experienced mentors. Drawing on Biggs’s presage–process–product (PPP) model, data were collected through semi-structured interviews (n = 12) and two focus group discussions (n = 6 each), engaging 18 unique mentors employed in organizations with 1,000 or more employees. Thematic analysis following Braun and Clarke’s six-phase protocol yielded four themes: (1) mentorship as strategic facilitation of organizational change; (2) mentorship as provision of emotional and psychological support; (3) empowering mentees through relationship-building; and (4) applying adaptive and reflective strategies. …

Pilot Intervention Of Wearable Smart Device And Coaching To Improve Sleep, Well-Being, And Professional Fulfilment Among Female Clinicians In Primary Care, Cheryl D. Stults, Sien Deng, Nina K. Szwerinski, Amandeep Mann, Sarina Le Sieur, Kimberly Ababseh, Tiffany Lam, Jill Kacher Cobb, Kelly Reilly, Stacey Upton, Dionyse Hartmann, Dennise Rosas, Laurie Gregg

Journal of Wellness

Introduction: Previous research has suggested an association between lack of sleep and well-being. Given higher rates of burnout among female clinicians, the Sutter Health “Joy of Work” team (a multidisciplinary group dedicated to improving organizational well-being) conducted a pilot among female clinicians in ambulatory services to assess factors associated with sleep, professional fulfillment, and intention to leave/reduce work hours.

Methods: The intervention consisted of several components: an Oura ring (a wearable smart ring device that tracks activity, sleep, and heart rate); health coaches who sent text messages to participants and advised those participants with additional resources and questions; and three …

From Readiness To Transformation: The Mediating Role Of Digital Maturity In Linking Ai Readiness To Organizational Change In Hospitals, Muhammad Ryan Adi Putra, Giovanni Reynaldo, Dewi Sri Surya Wuisan

Journal of Health Research

Background: Organizational readiness is essential for AI-enabled digital transformation as healthcare organizations increasingly integrate artificial intelligence (AI). However, empirical evidence regarding the relationship between AI readiness and organizational change, the mediating role of digital maturity, remains limited in healthcare settings. This study investigated the mediating role of digital maturity in the relationship between AI readiness and organizational change.

Methods: This cross-sectional study involved 300 healthcare professionals from two Indonesian hospitals: Persahabatan Hospital (n = 165) and St. Carolus Hospital (n = 135). Data were collected using a questionnaire and analyzed through Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess …

Exploring Burnout Impacting Graduate-Level Faculty And Leadership Within Health Profession Education In The United States: A Systematic Scoping Review, Megan Donaldson, Neeti Pathare, Garry Gilbert, Joshua Cleland

Internet Journal of Allied Health Sciences and Practice

Phenomenon: Full-time academic clinicians who hold faculty appointments in graduate‑level health professions education are expected to fulfill multiple, often competing role demands, including teaching, scholarship, service, clinical practice, and, for some, administrative leadership. These cumulative expectations can place faculty and educational leaders at elevated risk of burnout, particularly emotional exhaustion, with implications for career longevity, institutional stability, and educational quality. Approach: The objective of this systematic scoping review was to map how burnout has been conceptualized, measured, and associated with organizational and role-related factors among full-time graduate-level faculty and educational leaders in health and medical education (health professions) programs. Eligible …

Linking Institutional Ai Capability With Workforce Ai Fluency In Academic Health Institutions, Chin-Chi Kuo, Yu-Ting Lin, Cheng-Chieh Lin, Long-Bin Jeng, Bradley Chen

BioMedicine

No abstract provided.

Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi

Walden Dissertations and Doctoral Studies

The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …

Trauma Processing And Sleep Inconsistencies In Firefighters: A Proposed Program To Bridge Gaps And Set Heroes Up For Success, Megan Griffin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This doctoral paper presents a comprehensive review of the literature supporting the need for an integrated training program addressing sleep disruption, trauma exposure and processing, and substance use as a self-medication strategy among firefighter populations. Drawing on empirical research, the paper examines the prevalence and interaction of posttraumatic stress disorder (PTSD), moral injury, sleep disturbances, and substance use within this occupational group. The introduction provides operational definitions of PTSD and moral injury and synthesizes existing research on trauma exposure, sleep impairment, and substance use functions among firefighters. The literature review also highlights evidence-based, exposure informed interventions to facilitate adaptive trauma …