From Novice To Effective: Strengthening Clinical Education In Nursing, Stephanie Campbell

Doctor of Nursing Practice Projects

The professional transition from clinician to educator is often complicated by a lack of formal training and professional development. This gap in training and support compromises the delivery of nursing education and leads to feelings of inadequacy, diminished confidence, and higher rates of attrition. This quality improvement (QI) project seeks to improve the quality of clinical education by evaluating the impact of a structured onboarding process on a novice nurse educator’s self-efficacy and perceived support. Guided by Lewin’s Change Theory and Bandura’s Social Cognitive Theory, the project aims to enhance the onboarding process for novice nurse educators. The Find, Organize, …

Quality Improvement Project: Reimplementation Of Bedside Reporting, Veronicah Banga

Doctor of Nursing Practice Projects

Communication breakdown during nursing shift handoffs is a major patient safety challenge in healthcare today. At the project site, 85% of handovers occurred at the central nursing station, and most staff nurses expressed dissatisfaction with the quality of the bedside reporting. In psychiatric nursing, unique barriers exist that make bedside reporting challenging, including patient confidentiality and an individual's diagnosis. Such barriers eroded bedside reporting (BSR) over time, leading to measurable safety risks and nursing dissatisfaction. The purpose of this quality improvement project was to reintroduce bedside handoffs using the Situation, Background, Assessment, and Recommendation (SBAR) framework and to maintain BSR …

Centralizing Communication Intake To Improve Workflow Visibility And Engagement: A Quality Improvement Project In A Cancer Center's Education Division, Menatalla El-Sharkawi, Mohamed Ait Aiss

Advances in Cancer Education and Quality Improvement

Background: In large or complex organizations, multiple teams may be charged with managing different components of a project, initiative, or administrative assignment. When these teams have overlapping needs for information, the absence of a structured intake and tracking process can limit transparency, reduce efficiency, and hinder coordination across communication channels.

Methods: Drawing on principles of strategic communications and project management, we created a structured and centralized information sharing process for teams within the education division of a comprehensive cancer center. The intervention included workflow redesign, development of a standardized intake system, and use of real-time dashboard analytics to support operation …

Quality Improvement Project: Improving The Clinical Teaching Experience Through Clinical Adjunct Orientation, Elissa Saunders

Doctor of Nursing Practice Projects

Clinical adjunct nursing faculty often transition into academic roles without formal preparation, leading to role insecurity and high turnover rates that negatively impact student clinical experiences. The purpose of this quality improvement (QI) project was to implement a structured orientation checklist to improve perceived clinical teaching competency among novice clinical adjunct faculty. The project aimed to standardize onboarding and support the transition from clinical practice to academia. A quantitative pre-post intervention design was used with a convenience sample of clinical adjunct faculty employed for less than one year at a rural university nursing program. The project was guided by Kotter’s …

Strengthening Evaluation For Student Success, Hollan Scrivner

Doctor of Nursing Practice Projects

Student evaluation is an important factor in guiding students to develop self-confidence and gain competency in nursing skills. For evaluation to be effective, it must be consistent. The purpose of this quality improvement project is to implement a training program to improve consistency and interrater reliability among faculty conducting skill evaluations. The impact of the training program will be measured by a pre- and post-grading exercise using a skills rubric. Data will be extracted from the rubrics and entered into a codebook for data analysis. The project was guided by the theoretical framework of Stephens’ Star Model of Knowledge Transformation …

Quality Improvement Project: The Impact Of The Clinical Judgment Measurement Model In Nursing Faculty, Lamia Zeidan

Doctor of Nursing Practice Projects

Clinical judgment is essential for nursing practice and can be taught using the Clinical Judgment Measurement Model (CJMM). A needs assessment conducted at the project site revealed that students had limited clinical judgment skills, there was no emphasis on clinical judgment in nursing skills courses, and the faculty had a limited understanding of the CJMM. In response to the findings of the needs assessment, the quality improvement (QI) project was developed using a quasi-experimental design. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Educator theoretical framework, the project aimed to provide faculty with education on the CJMM and …

Building Connections For Care: A Practical Guide For Novice Nursing Professional Development Practitioners, Debra Hunt

Student Dissertations

Building Connections for Care is a practical textbook designed to support novice Nursing Professional Development Practitioners (NPDPs) as they transition from expert bedside clinicians to educational leaders within complex healthcare systems. Grounded in the Association for Nursing Professional Development (ANPD) practice model, the book integrates ethical foundations, communication strategies, leadership frameworks, and inquiry methods to build confidence and competence in the NPDP role. Chapters trace a developmental pathway from role transition and Benner’s novice-to-expert model through ethics and just culture, incivility and workplace culture, and communication skills including feedback, SMART goals, SBAR, and professional digital conduct. Subsequent chapters expand NPDP …

New Graduate Nurse Retention Strategies Toolkit For Managers And Leadership, Taryn Ryan

Student Scholarly Projects

Practice Problem:

Nurse retention has been a persistent issue for over a decade, with increasing turnover among new graduate nurses. Many new nurses leave the profession due to inadequate preparation for clinical roles and responsibilities.

PICOT:

The PICOT question that guided this project was: For nurse managers and leaders supporting new graduate nurses (P), how does the development of a best-practice retention toolkit (I), compared to existing retention practices (C), guide evidence-based strategies to improve nurse retention (O)?

Evidence:

Evidence indicates that new graduate nurses often feel insufficiently prepared for patient care responsibilities, compromising patient safety (Haddad et al., 2023; …

Three-Dimensional Imaging Of Neuronal Activation Patterns In Chronic Neuropathic Pain And Opioid Pharmacology, Madeline Martinez

Electronic Theses and Dissertations 2020 - Present

Chronic neuropathic pain severely diminishes quality of life, yet the supraspinal neural circuits that sustain pain perception and mediate analgesic relief remain incompletely characterized. While peripheral and spinal pain pathways are well established, relatively few studies have mapped pain- or opioid-related neuronal activation across the entire brain. This dissertation employed activity-dependent genetic labeling (TRAP2/Ai9), whole-brain tissue clearing, light sheet microscopy, and graph-theoretic network analysis to characterize brain-wide activation patterns across chronic pain and analgesic conditions in mice.

In Chapter 1, we mapped supraspinal neuronal activation in a bilateral spared nerve injury model of chronic neuropathic pain. Although no individual region …

Nurse Driven Intervention To Address Cesarean Section Rates, Cavetta Tulloch-Lewis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

Cesarean sections (C-sections) account for approximately one-third of births in the United States and remain the most common inpatient surgical procedure. Primary cesarean sections are a major contributor to rising rates, often leading to repeat cesareans in subsequent pregnancies. While medically necessary C-sections are lifesaving, their overuse in low-risk pregnancies is associated with increased maternal morbidity. Labor dystocia is one of the leading indications for primary cesarean delivery and may be mitigated through evidence-based, nurse-driven interventions such as maternal positioning and peanut ball utilization. Registered nurses are uniquely positioned to influence labor progression and promote vaginal birth through continuous …

Reducing Social Isolation In Elderly Hospice Patients Through Structured Social Interventions, Ashley Babayan

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a quality improvement organizational change initiative aimed at reducing social isolation among elderly hospice patients through structured social interventions. Social isolation is a significant psychosocial concern in hospice populations and is associated with increased emotional distress, depression, and decreased quality of life. Despite hospice care’s holistic philosophy, structured and standardized social engagement interventions are inconsistently implemented across settings, creating a gap in practice. The practice-focused question guiding this project was: In elderly hospice patients experiencing social isolation, how do structured social interventions (regular visits, group activities, and emotional support systems), compared to standard hospice …

Utilizing Proactive Rounding With Nursing Leadership To Improve Patient Satisfaction Scores In An Adult Medical-Surgical Unit, Lily A. Bogyah

Student Scholarly Projects

Practice Problem: Patient satisfaction is a key quality indicator that reflects patients’ perceptions of care and the healthcare system’s performance. Patient satisfaction scores at the project site were significantly lower than the national benchmark, particularly on the adult medical-surgical unit.

PICOT: The PICOT question that guided this project was: In patients on an adult medical-surgical unit (P), how does the use of proactive patient rounding conducted by nurse leaders (I) versus current practices alone without such rounding (C) affect patient satisfaction scores over an eight-week period (T)?

Evidence: A literature review of multiple studies found that implementing daily nurse leader …

Evaluating U.S. Health Policy Levers Using Difference-In-Differences: Hospital Acquisitions, Global Budgets, And Income Policies, Kola Adegoke

NYMC Student Theses and Dissertations

Abstract

Background: U.S. health policy relies on multiple levers to influence system performance, financial stability, and population health. This dissertation uses a three-paper portfolio to evaluate organizational change (hospital acquisitions), payment reform (Maryland all-payer global budgets), and income-related state policies, applying difference-in-differences (DiD) designs with prespecified diagnostics to support causal interpretation.

Methods: Study 1 examined hospital change-of-ownership (CHOW) acquisitions using a national hospital-year panel from RAND HCRIS (2014–2023), linked to CHOW timing data from 2016–2023. Effects on revenue outcomes were estimated using a staggered difference-in-differences design implemented with the Callaway and Sant’Anna estimator, using doubly robust inverse probability weighting, hospital-level …

Thalamic Organization Differentially Contributes To Clinical Conditions In Epilepsy, Qirui Zhang, Sam S. Javidi, Ankeeta Ankeeta, Michael R. Sperling, Zhiqiang Zhang, Joseph I. Tracy

Farber Institute for Neuroscience Faculty Papers

BACKGROUND: The thalamus plays an important role in key clinical conditions of focal temporal lobe epilepsy (TLE), but no investigation has examined whether the same thalamic local and connectome properties shape a patient's status across these different conditions.

METHODS: This retrospective longitudinal MRI study used resting-state fMRI and structural imaging to identify whole-brain focal/regional and connectome-level features associated with six binary clinical conditions of TLE (pre/post-surgery, seizure and neurocognitive outcomes, pathology, seizure subtype, and SOZ lateralization) in 91 patients across two centers (age range: 15-65 years) and 85 matched healthy participants (age range: 18-60 years).

RESULTS: Across conditions, relative to …

Challenges Of Electronic Medical Record Implementation From The Perspective Of Hospital Leaders In Riyadh, Kingdom Of Saudi Arabia's Public Hospitals: A Mixed-Methods Study, Atheer A. Alghamdi, Samiha H. Sayed

Saudi Medical Journal

Objectives: To assesses the challenges of implementing electronic medical records (EMR) from the leaders' perspective in public hospitals in Riyadh, Kingdom of Saudi Arabia (KSA), and explores their suggestions for improvement. Methods: A concurrent mixed research approach using a purposive sample of all hospital leaders (61) involved in EMR in 5 randomly selected public hospitals utilizing EMR in Riyadh. The researchers deployed a semi-structured interview schedule to collect the data. They used descriptive statistics and ordinal regression analysis for quantitative data, and thematic analysis for qualitative data. Results: Indicate that 80.3% of the hospital leaders had a good perception of …

The Development And Evaluation Of A Comprehensive Well-Being Instrument For Health Professionals - The Corewellness Index, Nicholas E. Anton, Lauren Ball, Jeffrey S. Levy, Nicky Beaudoin, Catherine F. Pipas

Journal of Wellness

Introduction: Healthcare worker wellness has received increasing attention from medical educators and healthcare systems given its importance to provider longevity and patient care. Wellness is multidimensional, and very few instruments evaluate all domains of wellness. Our team developed a comprehensive measure to evaluate the multi-dimensional nature of wellness. The purposes of this study were divided into four phases: phase 1) detail the development, design, and initial dissemination of the instrument, phase 2) collect feasibility and normative data for a diverse sample of healthcare workers, phase 3) evaluate the internal reliability of the measure and its component domains, and phase 4) …

Impediments To Transforming The Healthcare Delivery System: Shifting The Paradigm From Provider Centric To Patient Centric, Elizabeth A. Regan, Manasa Devi Chinta

Faculty Publications

Introduction: 

Stated aims for digital healthcare transformation frequently cite goals for better coordinated patient-centric systems. However, despite advances in medical science, digital technologies, health policies, and billions of dollars invested over the past 25 years, most healthcare providers are far from fully realizing the demonstrated benefits of today's digital technologies for improving patient care. Sharing information across healthcare systems remains challenging. Problems with fragmentation, quality, inequities, and rising costs of care delivery persist. A recent study of 1,026 U.S. hospital systems found that only 15.8 percent achieved a digital maturity level needed to provide digitally enabled healthcare services to better …

Evaluation Of Pulse Oximetry Alarm Fatigue And The Impact Of Spo2 Thresholds On Clinical Workflow: A Prospective Observational Study In A Kenyan Neonatal Unit, Bazil Masabo, Augustine Waswa, Jesse Coleman, Morris Ogero, Grace Irimu, Dorothy Chomba, Millicent Parsimei, Cynthia Shitote, Ferdinand Okwaro, William Macharia

Paediatrics and Child Health, East Africa

Introduction: Effective pulse oximetry monitoring in a newborn unit requires clinician action. However, if thresholds are not adapted to each neonate, frequent alarms cause alarm fatigue, which impacts the quality of patient monitoring, staff workload and clinical workflow.

Methods: We conducted an observational study from October 2021 to December 2022 in a Kenyan newborn unit which enrolled neonates through convenience sampling. Data were analysed in R using default thresholds of 85% to 96% for SpO2 and 90 to 200 bpm for PR.

Results: Among the 49 neonates enrolled, median hourly alarms per patient were 12 visual and …

Implementation Of A Standardized Suicide Risk Screening Protocol Using The Columbia-Suicide Severity Rating Scale (C-Ssrs) In An Outpatient Mental Health Clinic, Kemisola Ebietomiye

Doctor of Nursing Practice Projects

The outpatient mental health clinics across the United States lack consistent suicide risk assessment methods. This project developed standardized procedures which used Columbia-Suicide Severity Rating Scale (C-SSRS) assessment together with provider education and electronic health record systems to evaluate how these elements impacted provider self-efficacy and their ability to record screening results. The project used a pre-post design to examine (n=24) psychiatric providers at an urban outpatient clinic through the combined methods of Lewin's Change Theory and the Plan-Do-Study-Act framework. The General Self-Efficacy Scale measured provider self-efficacy, and structured EHR audits tracked documentation rates pre- and post-implementation over six weeks. …

Quality Improvement Project Standardizing Simulation In Nursing Education: A Faculty Training Initiative, Andrea Reyes

Doctor of Nursing Practice Projects

Simulation-based education is essential in nursing programs as clinical placement opportunities decline. However, inconsistent faculty preparation can compromise the quality of simulation delivery. The purpose of this quality improvement project was to implement and evaluate a standardized simulation faculty training initiative to determine its impact on nursing faculty's confidence in simulation facilitation. Guided by the Jeffries Simulation Framework and Lewin’s Change Theory, a quasi-experimental pre-post design was used to examine changes in faculty confidence following participation in a training program aligned with national standards and guidelines. Faculty confidence was measured using the Simulation Educator Needs Assessment Tool (SENAT) administered pre- …

Standardizing Patient-Centered And Trauma-Informed Communication Practices Among Staff In A Behavioral Health Setting, Jayla Brown

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate the effect of an evidence-based educational intervention on staff attitudes toward trauma-informed and patient-centered communication in an outpatient behavioral health clinic. Guided by Lewin’s Change Theory and Jean Watson’s Theory of Human Caring, the project aimed to improve staff knowledge, attitudes, and confidence in applying trauma-informed communication strategies across all clinic roles. An eight-week educational intervention based on the SAMHSA Trauma-Informed Care Toolkit was implemented for clinical and administrative staff. A quantitative pretest–posttest quasi-experimental design was used, with outcomes measured using an adapted Attitudes Related to Trauma-Informed Care scale. All …

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Addressing Faculty Gaps In The Psychiatric Mental Health Nurse Practitioner Program, Shea Brock

Doctor of Nursing Practice Projects

Graduate nursing programs increasingly rely on adjunct faculty to sustain enrollment growth; however, inconsistent onboarding processes may contribute to variability in faculty preparedness and job satisfaction. The purpose of this quality improvement project was to implement a standardized adjunct faculty education program and evaluate its impact on adjunct faculty knowledge and job satisfaction within an online Psychiatric–Mental Health Nurse Practitioner (PMHNP) program. A quantitative, quasi-experimental one-group pre–post design was utilized. Six adjunct faculty members (n = 6) completed a 10-item EXXAT Knowledge Survey and a 10-item Faculty Satisfaction Survey before and after participation in a structured one-hour education session focused …

Quality Improvement Project: Effectiveness Of Staff Education On Fall Prevention, Theresa Oahre Okoyomo

Doctor of Nursing Practice Projects

Falls increase injury and mortality rates and decrease patients' quality of life. Hospital falls also incur enormous financial burdens on hospitals. In 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for fall-related injuries. The problem addressed in this quality improvement project was staff confidence in fall prevention and hospital fall rates. The purpose is to improve staff confidence and reduce fall rates by 95 % within six weeks. The 2025 CDC/STEADI Algorithm for Fall Risk Screening, Assessment, and Intervention was the program of choice because it aligns with the hospital's fall-prevention policy. This project design is …

Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish

Doctor of Nursing Practice Projects

Medication administration errors remain a persistent threat to patient safety in emergency department settings, where high acuity, rapid throughput, and workflow interruptions increase vulnerability to preventable adverse events. The purpose of this Doctor of Nursing Practice quality improvement project was to increase medication-safety knowledge scores by at least 10% and reduce medication administration error rates by 20% within eight weeks among registered nurses in a freestanding emergency department in South Texas. The project was grounded in Lewin’s Change Theory as the theoretical framework and implemented using the Plan–Do–Study–Act quality improvement model. A quasi-experimental, single-group pretest–posttest design was used with a …

Operational Factors Influencing Branch Revenue In Multi-Branch Child Therapy Services, Muhammad Luthfi

Jurnal Administrasi Bisnis Terapan

The management of multi-branch child therapy services requires a strong understanding of operational factors that contribute to revenue performance. This study aims to analyze the relationship between operational days, occupancy rate, service attendance, and the number of practitioners in relation to branch revenue within a child therapy service organization operating in urban areas in Indonesia. A quantitative cross-sectional design was employed using operational data collected from 24 child therapy services. This study employed a quantitative cross-sectional design using branch-level operational data collected in December 2025 from 24 child therapy service branches. Multiple linear regression analysis was conducted to examine the …

Improving Benzodiazepine Refill Workflow And Communication Via Telehealth Using A Standardized Sbar Protocol, Hendricks Agwu

Doctor of Nursing Practice Projects

The development in telehealth operations in outpatient mental health care has enhanced access to care at the expense of creating challenges in communication and workflow, especially when it comes to dealing with high-risk substances like benzodiazepines. The role ambiguity, inaccurate refill timeline, documentation lapses and high chances of medication errors are caused by inconsistent communication during the process of telehealth refills. This quality improvement project was aimed at assessing the effects of applying a standardized Situation, Background, Assessment, Recommendation (SBAR) communication and documentation protocol to workflow efficiency, interprofessional communication, and medication safety when making benzodiazepine refills in a telehealth outpatient …

Roles And Strengths Of Therapeutic Recreation Professionals In Service Provision: A Strengths-Based Approach, M. Rebecca Genoe, Linda Ostryzniuk, Kathy Park, Sherri Nelson, Douglas G. Cripps, Donna Boser

The Qualitative Report

Therapeutic Recreation professionals work in healthcare and community-based settings where they utilize recreation and leisure to improve quality of life. Despite their contributions, Therapeutic Recreation often goes unrecognized as an important component of the healthcare team. The purpose of this study was to explore the strengths and successes of Therapeutic Recreation professionals. We aimed to explore how Therapeutic Recreation professionals identify and perceive their roles, and what strengths they use within their roles. Data was collected through 19 individual interviews and eight focus groups with Therapeutic Recreation professionals and analyzed thematically. The theme of “nurturing well-being through leisure” was generated …

Teaching Multicultural Counseling: A Phenomenological Exploration Of Counselor Educators’ Voices, Cameka Hazel, Paul Leheste, Raymond Blanchard

Journal of Counselor Preparation and Supervision

This study explored the perceptions of counselor educators who taught the graduate level multicultural counseling course. Six participants shared experiences, leading to four themes: personal and professional rewards, who is fit to teach? dealing with resistance and difficult conversations and limited time and class size. Implications for counselor education are discussed.

Emergency Nurses’ Perspectives On Workload, Stress, And Violence In The Context Of The U.S. Nursing Shortage, Wanda Marie Haynes

Walden Dissertations and Doctoral Studies

The nursing shortage is a critical global issue that significantly impacts emergency nurses (ER), leading to increased workloads, psychological stress, and heightened exposure to workplace violence (WPV). This phenomenon raises concerns among healthcare administrators and nurse leaders who seek strategies to improve retention and ensure quality patient care. The purpose of this qualitative study was to explore the meaning of workload, stress, and WPV among ER nurses during the U.S. nursing shortage. Guided by Herzberg’s two-factor theory, the study employed a phenomenological approach to capture nurses’ lived experiences. Data were collected through semi-structured interviews with eight ER nurses from diverse …