Digital Commons Network^™

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Technological Interventions For Reducing Climate Change Impacts On Health: An Overview Of Future Possibilities, Sujatha Alla, Vijay Kumar Chattu, Bawa Singh

Engineering Management & Systems Engineering Faculty Publications

Globally, over five million deaths annually are attributed to extreme weather events exacerbated by climate change, such as heatwaves, hurricanes, wildfires, droughts, and floods, which create health crises and economic losses. The 2015 Paris Declaration emphasized climate technology mechanisms, including research and development, to enhance resilience and reduce greenhouse gas emissions. Biotechnological advancements have mitigated about 20% of economic losses since the 1960s, highlighting technology’s potential to address climate-induced health risks.

Improving Blood Pressure Control Through Lifestyle Modification In African Americans Adults With Uncontrolled Hypertension, Tasha Leonard

Doctor of Nursing Practice (DNP) Scholarly Projects

African American adults have the highest incidence of uncontrolled hypertension (HTN), leading to premature cardiovascular death in Texas and worldwide. In a South Texas cardiac clinic, over 90% of African American adults with HTN also have obesity, compared with 55% of their Caucasian counterparts. The most prevalent factor affecting this group is poor understanding of blood pressure management, which leads to nonadherence to dietary and exercise recommendations, medication regimens, and blood pressure monitoring. The objective was to determine whether lifestyle modification using a hypertensive bundle would improve blood pressure management among African American adults in the clinical setting. The initiative …

Implementing A Mental Health Workshop To Mitigate Burnout And Improve Job Satisfaction Among Psychiatric Technicians: A Mixed-Methods Case Study, John P. Smith

DNP Research Projects

Abstract 

Burnout among psychiatric technicians contributes to emotional exhaustion, decreased job satisfaction, workforce instability, and reduced quality of patient care. Despite increasing recognition of healthcare worker well-being as a priority, limited evidence exists regarding interventions specifically designed for psychiatric technicians. The purpose of this Doctor of Nursing Practice project was to implement and evaluate a structured mental health workshop designed to reduce burnout and improve job satisfaction among psychiatric technicians employed in inpatient, outpatient, and group home mental health settings. A mixed-methods case study utilizing a quasi-experimental pretest-posttest design was conducted with a convenience sample of 41 participants. Quantitative data …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Updating Order Set Review Policy To Improve Adherence To Evidence-Based Practice In A Multi-Hospital System, Corynne Lurie

West Chester University Graduate Theses, Dissertations, and Final Projects

Ensuring that clinical order sets reflect current evidence-based practice is essential to delivering safe, high-quality, and consistent patient care across health systems. In multi-hospital organizations, maintaining alignment across facilities presents additional challenges, including variability in workflow, stakeholder involvement, and policy adherence. This quality improvement project evaluated the existing order set review process within a three-hospital health system to determine whether current policies effectively support system-wide needs and promote best practices. Guided by Lewin’s Change Theory, a qualitative descriptive design was used to assess current workflows and gather feedback from stakeholders involved in order set development and review. Survey data, with …

Implementation Of The Downes Scoring Tool, Jennifer Oney

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

Respiratory Distress Syndrome (RDS) is a leading cause of morbidity and mortality in premature infants. It is managed with continuous positive airway pressure (CPAP), but CPAP can mask the signs of RDS, and delay surfactant therapy.

Purpose

This quality improvement project (QI) was to assess healthcare providers’ confidence in RDS and surfactant therapy through pre- and post- surveys and provided education on RDS and the implementation of the Simplified Downes Scoring Tool to assess respiratory distress in premature infants (25-36 weeks gestation).

Methods

In a Level III NICU, healthcare providers received education on RDS and the scoring Tool, they …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Combating Pressure Injuries In Critical Care: A Dnp Project On Nursing Education And Prevention Strategies In The Icu, Tijuana M. Johnson

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) are preventable complications that significantly increase patient morbidity, mortality, length of stay, and healthcare costs, particularly in intensive care units (ICUs). At a rural 146-bed hospital, the ICU pressure injury rate of 1.17 per 1,000 discharges exceeded the national benchmark of 0.58 per 1.000 discharges, identifying a critical gap in prevention practices. This Doctor of Nursing Practice (DNP) project aimed to improve ICU nurses' knowledge of pressure injury prevention and reduce unit-based educational intervention grounded in Patricia Benner’s Novice to Expert Theory and implemented using the Plan-Do-Study-Act (PDSA) quality improvement framework.

A pre-and post-intervention design was …

Increasing Patient Feedback Survey Completions Through Patient-Centered Nursing Communication: A Quality Improvement Project, Lindsey E. Pawlowski

Master's Theses and Capstones

Background: Patient feedback is essential to providing the best possible nursing care. Positive patient experiences can impact overall patient satisfaction, loyalty, and trust.

Local Problem: On a pediatric unit at a New England hospital, an assessment of the microsystem revealed that there was a low number of monthly patient feedback survey completions, which limited insight into patient experiences.

Aim Statement: The primary aim of this project was to increase the number of monthly National Research Corporation (NRC) surveys to ten by June 30, 2026.

Methods: This quality improvement project was guided by the Plan-Do-Study-Act (PDSA) model. The first stage of …

Exploring Relational Leadership And Psychological Safety During Ai Integration In The Workplace, Solmaz Kaynama

Antioch University Dissertations & Theses

This study explores employee psychological safety, or its lack, during artificial intelligence (AI) integration in the workplace through a relational leadership lens. The population included employees of for-profit business corporations currently integrating or adopting AI technologies (N = 14). Participants completed in-depth, semi-structured interviews. Results showed eight themes: relational leadership creates a psychologically safe workplace climate; unsupportive and dysfunctional leadership erodes trust and psychological safety; psychological safety determines whether employees speak up openly or hold back; employees’ experience daily work through workplace culture, pace, and remote or hybrid conditions; AI may delivers immediate productivity benefits while introducing new psychological and …

Navigating An Uncharted Path: Chief Diversity Officer Challenges In Creating And Implementing A Dei Strategy Plan Within Major Hospital Systems, Diane Shines Mcdaniel

Antioch University Dissertations & Theses

This qualitative phenomenological study investigated the major challenges Chief Diversity Officers (CDOs) face when creating and implementing DEI strategy plans within major hospital systems in the United States. The study was guided by one research question: What are the major challenges that Chief Diversity Officers face in creating and implementing a DEI strategy plan within major U.S. hospital systems? A phenomenological design was used to examine the challenges of six Chief Diversity Officers serving in major U.S. hospitals as they led DEI strategy planning and implementation. Data were generated through semi-structured interviews consisting of eight open-ended questions designed to elicit …

Self-Leadership And Perceptions Of Artificial Intelligence: A Single-Case Study, Patrik Garren

Graduate Theses, Dissertations, and Problem Reports (ETD)

The purpose of this single-case qualitative project is to uncover how self-leadership’s behavioral and cognitive strategies influence perceptions of Artificial Intelligence (AI) and AI adoption. While existing literature acknowledges that there is an association between self-leadership, technology’s perceived usefulness and ease of use, as well as comfort with AI preparedness and its professional impact, there is limited research on how self-leadership shapes perceptions of AI and AI adoption in real-life contexts. To fill this gap in contemporary literature, this project analyzes qualitative semi-structured interviews with 25 healthcare professionals involved in the implementation of ‘AI Model 1’ at their mid-sized United …

Enhancing Military Health System Organizational Efficiency And Quality Of Care Through A Social-Ecological Framework, Eric L. Peipelman

College of Graduate Studies: Theses & Dissertations

Timely and fair adjudication of incivility-related actions within the Department of Defense (DoD) and Military Health System (MHS) is increasingly crucial for maintaining accountability, mission readiness, and quality of care. Ongoing delays in resolving workplace complaints and inefficiencies in resource-heavy adjudications highlight the need to shift from reactive complaint handling toward proactive civility promotion and transparent decision-making. This Integrated Learning Experience (ILE) introduces the Peipelman Civility Discussion and Assessment Toolkit (PCDAT)—a comprehensive, evidence-based framework designed to improve civility, optimize resources, and enhance communication, even in the MHS. Based on the Social-Ecological Model (SEM) and adapted from the Workplace Power and …

From Vision To Impact: Strategic Planning For The South Health District, Jason D. Butler Jr

College of Graduate Studies: Theses & Dissertations

This study presents a community health assessment and strategic planning process for the South Health District (SHD), a rural, multi-county public health district.  Using a mixed-methods approach, quantitative surveys and qualitative data from County Nurse Managers, County Boards of Health, and internal staff were integrated with secondary sources to identify community health priorities and organizational gaps.  Broad stakeholder engagement through surveys, SWOT workshops, and town-hall meetings ensured credibility and contextual relevance.

Findings revealed challenges in behavioral health, substance abuse, chronic disease, access to preventive services, transportation, workforce capacity, communication, and infrastructure.  Four strategic issues—Communication, Workforce Development and Retention, Purpose-Driven District, …

Participatory Systems Modeling In Implementation Research: Exploring Benefits, Facilitators, And Future Needs, Natalie Riva Smith, Jennifer L Cruz, Jessica Gannon, Stephanie Mazzucca-Ragan

2020-Current year OA Pubs

BACKGROUND: Implementation science increasingly uses participatory systems modeling (PSM) approaches to handle the complexity inherent to implementation science issues. To support the process of integrating PSM with implementation science, we aimed to understand and explicate the benefits, facilitators, and future needs of applying PSM to implementation research.

METHODS: We conducted semi-structured qualitative interviews with 23 researchers (n = 18) and practitioners (n = 5). We purposively sampled participants and identified additional participants through recommendations. Interviews were inductively analyzed. Key concepts were identified via iterative description, comparison, and conceptualization.

RESULTS: Engagement with people in the system was typically focused in earlier …

From Mandate To Meaning: Designing Implementation Supports For Organizational Readiness In Behavioral Health Service Planning, Lauren K. Mergen

Theses and Dissertations--Education Sciences

Behavioral health agencies often struggle to translate the Transformational Collaborative Outcomes Management (TCOM) framework into practice when implementation is externally mandated. This study examined how educational leaders can support meaningful use of TCOM tools under a Midwestern state’s October 2024 requirement that behavioral health providers use the state Child and Adolescent Needs and Strengths assessment in service planning.

Using a Mixed Methods Action Research design, the study progressed through six phases: Diagnosis, Reconnaissance, Planning, Acting, Evaluation, and Monitoring. The Diagnosis Phase identified a knowledge-to-practice gap and weaknesses in implementation support infrastructure. Practitioner surveys administered immediately after training and six months …

Clinical Informatics Education To Advance Learning Health Systems: A Scoping Review, Alexandra Zingg, L Ida Tovar, Laura Witte, Kelsey L Koym, Kyler Godwin

Library Staff Publications

Introduction: Learning health systems leverage clinical data and knowledge to advance healthcare quality. Effective training in informatics concepts and tools is essential for medical trainees to become health system experts and contributors to positive organizational change. The objective of this study is to summarize characteristics of existing clinical informatics training programs and map these to recommended Learning Health System informatics competencies. We aim to answer the following research questions: (1) How are academic medical institutions implementing informatics education initiatives for medical trainees? (2) Are these initiatives implementing recommended informatics competencies? and (3) How effective are these initiatives according to established …

Implementing Sbar-Based Staff Education And A Diabetes-Specific Discharge Checklist To Reduce Patient Identification Errors During Handoffs, Maragarate Nesoa

Walden Dissertations and Doctoral Studies

This doctoral project was an organization change initiative using staff education to reduce patient identification errors during handoffs among older adults with Type 2 Diabetes (T2DM). Misidentification during transitions of care contributes to medication errors, unnecessary readmissions, and preventable adverse events

Abc Pharmaceutical Company Change Model: Implementing J.P. Kotter's 8-Step And Adkar Change Models For Ethical Alignment, Shelbi B. Chandler, Amalfi Gayosso, Alison Lawton, Ali Holness-Roland

The Scholarship Without Borders Journal

In this paper, we use the pseudonym ABC Pharmaceuticals (ABC) to refer to the company under examination, GlaxoSmithKline (GSK). ABC Pharmaceutical (ABC) must assess, adapt, and change to ensure regulatory compliance, maintain and attract employees, and remain competitive. ABC has a history of erroneous practices and is at risk internally with employees, and externally with regulators and the public sectors. The authors applied J.P. Kotter’s (1996) 8-step and the ADKAR (Hiatt, 2006) models for change management. J.P. Kotter’s top-down model addresses leadership’s role in creating a compelling vision aligned with its actions, and the ADKAR bottom-up model assesses employees’ readiness …

Bridging The Gap: Optimizing Outpatient Care Delivery In Rural Kenya Through A Telemedicine Workflow Training Initiative, Elizabeth K. Bennett

Doctoral Dissertations and Projects

Access to timely, high-quality outpatient care in rural Kenya is constrained by workforce shortages, geographic barriers, and inefficiencies in care delivery. This Doctor of Nursing Practice project evaluated the impact of implementing a structured telemedicine workflow and training program for a regional mission hospital in the highlands of Western Kenya and its satellite outpatient clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's Change Theory, and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework, the project employed a quasi-experimental, pre-post design, with eight medical providers participating in structured workshops, interactive telemedicine simulations, and workflow integration exercises. Impacts were …

Transition-To-Practice Program For Aprn Msn Graduates, Jennifer Nneoma Nwosu

Walden Dissertations and Doctoral Studies

The transition from graduate education to clinical practice marks a pivotal point in the professional journey of advanced practice registered nurses (APRNs). Despite rigorous preparation, many APRN MSN graduates struggle to adapt to the complex expectations of autonomous practice. The lack of structured mentorship, inconsistent orientation processes, and unclear performance expectations contribute to high stress, role confusion, and early turnover. This Doctor of Nursing Practice Executive Leadership project addressed this critical issue by evaluating whether an interprofessional team could achieve consensus on developing a best practice program to guide APRN MSN graduates’ transition to independent clinical practice. This initiative was …

A Competency Based Pressure Injury Management Program, Madina Qadir

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project aims to implement a simulation-based wound management program to address critical gaps in nurses’ competencies for managing pressure injuries (PIs). The initiative seeks to enhance nurses’ knowledge, clinical skills, and confidence in wound assessment and advanced therapies, fostering evidence-based practice and consistent care delivery. Effective PI management is vital for improving patient outcomes, reducing healing times, and minimizing complications. Yet, nursing education and competency gaps often lead to inconsistent care and increased healthcare costs. A structured competency-based pressure injury management (CB PIM) program integrates evidence-based didactic lectures and interactive simulation-based skills stations to cover essential topics, including wound …

A Cross-Sectional Study On Patient Safety Attitudes And Their Determinants Among Medical Staff In Malaysian Public Specialist Hospitals, Sharifah Balqis Sayed Abdul Hamid, Aniza Ismail, Saperi Sulong

Makara Journal of Health Research

Introduction: This study aimed to assess the baseline level and mean scores of patient safety attitude domains among doctors and nurses in Malaysian public hospitals and to identify determinants associated with these attitudes across six domains: teamwork, safety climate, working conditions, job satisfaction, stress recognition, and perception of management.

Methods: A cross-sectional study was conducted using the Safety Attitudes Questionnaire (SAQ) among 142 doctors and 231 nurses from three public tertiary hospitals. Participants were selected through proportionate stratified random sampling. Data were analyzed using descriptive, bivariate, and multivariate methods.

Results: The study achieved an 81% response rate. …

A Program Evaluation Of Universal Screening For Depression In The Primary Care Setting, Samantha W. Burns

Doctoral Projects

Depression is a chronic condition affecting millions of Americans annually and is often associated with poor clinical outcomes, multiple co-morbidities, a negative economic impact, and an increased mortality rate. Many primary care settings have implemented universal depression screening programs following the recommendations of governing healthcare entities such as the United States Preventive Services Task Force (USPSTF) and Center for Medicare and Medicaid Services (CMS). Due to positive benefit, universal depression screenings have now been included as a quality measure in the Merit-based Incentive Payment System (MIPS) to increase organizational reimbursement. The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening …

Behind The Badge: Effects Of Stress And Trauma In Policing -- Understanding The Importance Of Evidence-Based Prevention, Early Intervention, And Wellness Programs, Jessica Rolshouse

Master of Arts in Human Services

Law enforcement officers are exposed to occupational stress and trauma routinely and at rates that far exceed the general population. This chronic exposure places them at risk for physical and psychological injury and negative outcomes to include mental health disorders including burnout, anxiety, depression, and PTSD. Prolonged exposure to occupational stress and trauma also increases the risk of suicidal ideation and dying by suicide, the most tragic outcome of the stress law enforcement officers face. This literature review focuses on individual risk factors, occupational stress, and trauma, and the development of mental health disorders in law enforcement officers. It also …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

Reimagining Nurse Education: Virtual Reality & Didactic Education For Better Nurse Handoff And Documentation, Haley M. Whalen

Master's Projects and Capstones

Setting: The pediatric perianesthesia unit (pre-operative and post-anesthesia care unit). Problem: Gaps in perianesthesia documentation contribute to poor handoff communication, leading to adverse events and increased hospital costs. Additionally, inconsistent documentation reduces clarity and consistency during handoffs. Context: Staff in the microsystem reported low confidence scores with required OP-Time documentation, inconsistent workflows, and I-PASS handoff expectations. These factors contribute to incomplete charting and a lack of standardization across providers. Interventions: A two-part educational intervention was conducted, consisting of eight sessions. The first component is a Virtual Reality (VR) simulation that demonstrates an accurate perianesthesia I-PASS handoff. The second …

From Incomplete To Impactful—Finalizing Unfinished Nursing Projects In Nart And Polypharmacy For Lasting Improvement, Paula Thanh Nhat Pham, Armine Lianna Chamichyan, Anastasia Yerofeyeva, Stelene Alexis Tragus

Master's Projects and Capstones

This quality improvement project addressed the problem of incomplete or unsustained clinical initiatives at a long-term care facility by introducing Kotter’s Change Model, an evidence-based framework designed to support and sustain lasting improvements in clinical practice. Within the context of a religious-based residential community for older adults with complex chronic needs, the objective was to strengthen the facility’s capacity to implement and sustain change more effectively. By using two previously unfinished initiatives, the NaRT triage tool and Polypharmacy management process, the project applied Kotter’s model to evaluate how structured change strategies can improve staff engagement, leadership alignment, and long-term project …

Improving Pressure Injury Prevention With Educational Programs For Caregivers And Nurses, Michella B. Kahanding

Master's Projects and Capstones

Problem: Pressure injuries are preventable with adequate interventions and knowledge by healthcare staff; however, skilled nursing facilities struggle with pressure ulcer prevention (PUP). Patient suffering and associated costs with treating these injuries are considerable.

Context: Staff education in knowledge regarding PUP is lacking, and annual PUP education is ineffective in reducing the number of pressure injuries in these facilities.

Interventions: Staff education on prevention strategies includes education, pre- and post-knowledge assessments, return demonstration and product use will be implemented

Measures: Results from the baseline knowledge of appropriate PUP in caregivers, pre- and post-test for knowledge retention, teach back techniques to …