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Predictors Of Healthcare Providers' Readiness For Health System Transformation In Saudi Arabia, Ahmed Ali Alasiri

Health Services Research Dissertations

The healthcare system in Saudi Arabia is undergoing significant health reform to warrant sustainable welfare provision. Privatization or public-private partnerships (PPPs) were introduced in 2021 and outlined the vision for the health system for 2023. The planned initiatives aim to be comprehensive and effectively reach individuals and society, including citizens, noncitizens, and visitors. This dissertation seeks to study and explore privatization, the role of healthcare providers, and their capacity to adapt to the transformation of the healthcare system. To achieve this ambitious goal, several interrelated projects have been undertaken. The first project was a systematic review aimed at studying the …

A Workplace Posture Initiative To Reduce Work-Related Musculoskeletal Disorders, Carrie Isaac

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Work-related musculoskeletal disorders (WRMSDs) are a leading cause of occupational injury and discomfort in industrial workplaces. Although an ergonomic program existed at the project site, a formalized process to detect postural misalignments early had not been established. Relying on employee self-reporting, delayed intervention, and limited opportunities to prevent injuries before they progress.

Aim of the Project: A proactive posture screening program using PostureScreen® was implemented to identify postural deviations that could contribute to WRMSDs. Emphasis was placed on supporting employees through early awareness of posture-related issues and evaluation of alignment improvements following individualized intervention.

Review of the Evidence: Evidence …

Policy Review Of The Aha Clinical Practice Guideline For Congestive Heart Failure: Evaluating Best Practices, Brenda E. Garcia

Student Scholarly Projects

Practice Problem: Congestive heart failure (CHF) is a significant public health challenge that impacts various populations and contributes to rising hospital admission rates.

PICOT: The PICOT question that guided this scholarly project was: For healthcare policymakers and interprofessional teams (P), how does a policy review of the American Heart Association’s Clinical Practice Guidelines for Heart Failure (I), guided by the CDC’s Polaris Framework (C), conducted over a 12-week period (T), evaluate alignment with evidence-based practices and potential for adoption in the care of patients with congestive heart failure (O)?

Evidence: This scholarly project focused on reviewing the current clinical guidelines …

Emergency Nurses’ Perceptions Of A Trauma-Informed Organizational Climate: A Cross-Sectional Study, Audrey Kobina

Nursing Theses and Dissertations

Healthcare leaders face numerous challenges in today’s complex healthcare environment. The most pressing issues are staffing shortages and burnout among healthcare workers. By 2025, the U.S. healthcare system could experience a shortfall of up to 450,000 nurses, or 20% fewer nurses than needed to provide adequate patient care. High job dissatisfaction and burnout levels are significant factors driving many nurses away from the profession. This three-paper dissertation portfolio addressed how trauma-informed approaches and practices can enhance the work environment by establishing trauma-informed organizational climates to mitigate burnout. Understanding the impact of trauma-informed practices within healthcare systems supports the nursing workforce. …

The Impact Of Trauma-Informed Care Education On Healthcare Providers And Staff In An Outpatient Clinic: A Holistic Approach To Diversity, Equity, And Inclusion, Ngozi Azu

Doctoral Dissertations and Projects

Trauma is an emotional response that an individual may experience due to exposure to an event beyond their ability to manage. Trauma-informed care (TIC) is essential in health care for creating a supportive and safe atmosphere for individuals with a trauma history, but many health providers and staff lack proper training in TIC. The purpose of this project was to design, implement, and evaluate a comprehensive education program focused on TIC for health care providers and staff in an outpatient clinic setting. A quasi-experimental methodology and the Iowa Model of Evidence-Based Practice were used. Quantitative and qualitative data were collected …

Enhancing Medication Communication In The Acute Care Setting To Strengthen Patient Comprehension And Retention, Ashleigh C. Christensen

Student Scholarly Projects

Practice Problem: Research has shown that breakdowns in communication, especially in the context of medication education, play a critical role in the delivery of safe and effective patient care. These findings underscore the need to prioritize effective communication in medication education. In the acute care setting, effective communication is essential for ensuring patient safety, adherence, and improved patient-centered outcomes.

PICOT: In clinical staff providing direct patient care in the acute care setting (P), does the implementation of the evidence-based teach-back method (I), as compared to current practice (C), improve patient knowledge, understanding, and self-management upon discharge (O), over ten weeks …

Controlling Hypertension In The African American Population Through Dash Diet Education, Tanya K. Mccaskill

Doctor of Nursing Practice Projects

Hypertension disproportionately affects African Americans, contributing to elevated risks of stroke, cardiovascular disease, and kidney failure. Despite the well-established benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, its adoption remains limited due to cultural, socioeconomic, and health literacy barriers. This Quality Improvement (QI) project aimed to evaluate the effectiveness of a culturally tailored DASH diet education intervention in improving nutritional knowledge among African American adults with hypertension (HTN). Using a quasi-experimental pre-post intervention design, 50 participants received a structured educational session during a single clinic visit, which included counseling, printed materials, and sample menus. The intervention was guided …

Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo

Student Scholarly Projects

Practice Problem: Burnout Syndrome (BS) is a serious problem in emergency department (ED) nurses and is associated with higher nurse turnover rates. A burnout prevention toolkit is needed.

PICOT: The project was guided by the following PICO question: "For emergency department nurses (P), how does the development of the best practice burnout prevention toolkit (I), compared to the absence of a structured intervention (C), support the establishment of nurse burnout best practices when evaluated using the CDC Program Evaluation Framework? (O)".

Evidence: The analysis of the literature supported the implementation of active interventions in the form of workshops.

Intervention: A …

Quality Improvement Project Educating Nursing Faculty On The Lasater Clinical Judgment Rubric In Simulation, Tiffany Shivers

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance nursing faculty preparedness in simulation-based education by increasing knowledge and self-efficacy using the Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental, one-group pre-/post-intervention design was used to evaluate outcomes among ten faculty participants. The intervention consisted of an educational session introducing the LCJR and structured debriefing techniques. Data were collected using a knowledge assessment and the General Self-Efficacy Scale. Descriptive statistics and the Wilcoxon Signed-Rank Test were used to analyze changes in scores. Results demonstrated statistically significant improvements in both knowledge (Z = –2.805, p = .005) and self-efficacy (Z = –2.666, p = …

Enhancing Emr Training Through Programmatic Assessment: Aligning Curriculum With Organizational Needs, Amanda Coleman

MSHS Student Capstones

No abstract provided.

National Patient Safety Goals: Reducing Health Care Disparities In Adult Patients With Alcohol Misuse, Jolie M. Carpenter

Doctor of Nursing Practice Projects

Background: An estimated 76 million people worldwide suffer from alcohol use disorder, accounting for almost two million deaths annually. The Joint Commission has made it a requirement to screen all patients admitted to an inpatient facility for health-related social needs, including alcohol use. By doing so, outpatient resources can be provided appropriately.

Purpose: The facility of interest does not currently have a discharge follow-up protocol. The purpose of this project was to implement an evidence-based protocol to follow-up one week after discharge to determine if patients accessed the community resources provided for alcohol use disorder and to determine whether the …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Enhancing Patient Outcomes: The Sepsis Navigator Approach, Temeka L. Parker

Doctor of Nursing Practice Projects

Background: Sepsis is the leading cause of hospital mortality, accounting for over $20 billion dollars in total healthcare costs and more than 5 million deaths annually worldwide. The increased burden of sepsis led the Centers for Medicare and Medicaid (CMS) to institute a quality core measure known as the Severe Sepsis and Septic Shock Management Bundle (SEP-1) as a protocol for sepsis treatment. CMS reports national SEP-1 compliance at 62% and 61% for Alabama. The undisclosed project site reports a much lower SEP-1 compliance average of 49% over six months. Compliance with the SEP-1 bundle improves overall patient outcomes and …

Enhancing Diabetes Care In Adult Patients With Type 2 Diabetes In An Outpatient Setting, Osayanmo Ojo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition associated with significant morbidity, particularly among underserved populations. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to improve diabetes care among adult patients with poorly controlled T2DM (A1C > 9%) in an outpatient primary care clinic by increasing referrals to the Diabetes Self-Management Education (DSME) program. Guided by the Plan-Do-Study-Act (PDSA) cycle and the OhioHealth Change Management (OHCM) model, the project implemented structured interventions including standardized DSME referral workflows, electronic health record (EHR) prompts, provider education, and culturally tailored communication strategies.

The 12-week initiative targeted 68 eligible patients. …

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Implementing An Evidence-Based Transitional Care Toolkit To Reduce Postpartum Readmissions In Women With Chronic Conditions, Cassidy La Fleur

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postpartum women with preexisting chronic conditions are at increased risk of hospital readmissions due to fragmented care transitions and poor follow-up adherence. At the project site, the 30-day postpartum readmission rate was 10%, exceeding the national benchmark of 7.15%. Gaps in standardized discharge planning and limited patient engagement were identified as contributing factors.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce 30-day postpartum readmissions in women with chronic health conditions by implementing an evidence-based transitional care toolkit within a women’s outpatient clinic.

Review of the Evidence: Evidence supports the use of structured, …

Improving Provider Documentation For Procedure Authorizations: A Nursing Perspective On Enhancing Outcomes And Compliance, Juli Legg

All Doctor of Nursing Practice (DNP) Scholarly Projects

Insurance denials resulting from non-standardized documentation and communication gaps in the prior authorization process adversely impacted financial performance and patient care within the electrophysiology (EP) department of a large Midwest academic medical center. High denial rates for costly procedures revealed a need for improved alignment with payer medical necessity criteria. This quality improvement (QI) project aimed to enhance provider documentation, reduce denials, improve care delivery, and increase revenue by implementing standardized documentation templates. A review of the literature supports that standardized documentation and clinical decision support tools enhance consistency, reduce errors, and improve prior authorization success rates. Guided by the …

Quality Improvement Project Improving Nurse Self-Efficacy In Completing Person-Centered Care Plans, Divya Iype

Doctor of Nursing Practice Projects

Person-centered care planning (PCCP) is a cornerstone of psychiatric nursing practice, yet many nurses lack the training and confidence to implement it effectively. This quality improvement project addressed a practice gap in nurse self-efficacy regarding PCCP completion at an acute psychiatric hospital. A care plan completion rate of 88%, below the institutional benchmark of 100%, prompted an intervention. This project’s purpose was to enhance nurse self-efficacy in implementing PCCP by providing focused training on trauma-informed care, cultural competence, and person-centered care planning. The project used a pre-post intervention design to assess the impact of the intervention, with self-efficacy measured using …

Quality Improvement Project Improving Employee Satisfaction And Retention Through A Structured Training Process, Dawn Lundgren

Doctor of Nursing Practice Projects

The DNP project aimed to evaluate the impact of a structured new-hire training program on employee retention and job satisfaction within a hospice organization. Insufficient training for new employees can lead to a high staff turnover rate, stress, decreased job satisfaction, and poor quality of care. The quality improvement project utilized a pre-post intervention design over an eight-week period, comparing retention rates and job satisfaction scores before and after project implementation. Employee retention was measured as a binary outcome (retained or left), and job satisfaction was assessed through a seven-item survey rated on a five-point Likert scale. A total of …

Identifying And Exploring Successful Leadership Strategies To Improve Nurse Retention, Jennifer Triggs Rickerson

Walden Dissertations and Doctoral Studies

Nurse turnover has become a critical concern in healthcare, as low retention rates lead to decreased patient care quality and increased operational costs. A critical issue for hospital stakeholders is that many nursing leaders lack strategies to improve nursing retention. Grounded in the leader-member exchange theory, the purpose of this qualitative pragmatic inquiry was to identify and explore successful leadership strategies used by nurse managers in the Pacific South region of the United States to improve nurse retention. The study included interviews with six nurse managers who successfully implemented retention strategies. Data were collected through semistructured interviews and publicly available …

Quality Improvement Project Reducing Pediatric Anesthesia In Magnetic Resonance Imaging: The Role Of Preparedness And Education, Rachel Turner

Doctor of Nursing Practice Projects

Pediatric hematology-oncology patients undergo general anesthesia (GA) for various medical procedures, including magnetic resonance imaging (MRI) scans. Overexposure to GA increases the potential for long-term neurocognitive effects in pediatric patients. Despite the growing research literature on GA-related neurotoxicity and the Food and Drug Administration's (FDA) warnings, advanced practice providers (APP) often lack the knowledge to advocate for and support reductions in pediatric GA use. The Doctor of Nurse Practice (DNP) quality improvement (QI) project aimed to reduce unnecessary GA in pediatric hematology-oncology patients undergoing MRI scans by addressing the primary clinic APPs' knowledge deficits through interprofessional education (IPE). Structured in …

Quality Improvement Project Enhancing Communication Perceptions Among Nursing Staff In The Operating Room, Denis Awu

Doctor of Nursing Practice Projects

Effective communication in the operating room (OR) is crucial for ensuring patient safety and optimal surgical outcomes. Communication breakdowns among surgical teams are a leading cause of sentinel events and procedural errors. This quality improvement (QI) project aimed to enhance communication perception among OR nursing staff through a structured training program focused on verbal, non-verbal, active listening, and communication under pressure. Grounded in Social Cognitive Theory and implemented using both Kotter’s 8-Step Change Model and the Plan-Do-Study-Act (PDSA) cycle, the intervention included interactive workshops and simulation exercises delivered over a six-week period. A total of 50 registered nurses participated in …

Enhancing Education In Nursing Skills: The Impact Of Simulation Use On Faculty Self -Efficacy, Annie Kyle

Doctor of Nursing Practice Projects

This quality improvement (QI) project aimed to improve nursing faculty self-efficacy in teaching nursing skills using medium- and high-fidelity simulation. The problem addressed was the increasing number of students requiring multiple attempts to pass skills checkoffs, with some ultimately being withdrawn from the program. Faculty at the project site reported a lack of training and confidence in utilizing simulation technology effectively. A quasi-experimental design was used with a single group of full-time faculty (n=6), who received simulation training and completed the Self-Efficacy Towards Teaching Inventory for Nurse Educators (SETTI-NE) before and after the intervention. The data analysis was conducted using …

Improving Patient Outcomes Post-Discharge: Implementing Evidence-Based Discharge Planning For High-Risk Mental Health And Substance Use Disorder Populations, Margaret Phillips

Doctor of Nursing Practice Projects

A significant gap in standardized discharge procedures was identified at a nonprofit, community-based clinic serving male residential patients with substance use disorder (SUD) and co-occurring mental health conditions. The lack of a standardized discharge process led to poor follow-up appointment adherence, poor medication adherence and increased risk of relapse. This quality improvement (QI) project aimed to address these issues through the implementation of a cross-departmental discharge process that produced tailored Individualized Discharge Plans (IDP) or each patient, using the Donabedian and Kotter’s 8-Step Change models as guiding frameworks. Data were collected using custom-built tracking tools over two four-week periods, pre- …

Quality Improvement Project: Perioperative Recruitment Process Improvement Through Nursing Student Clinical Experience, Traci Boren

Doctor of Nursing Practice Projects

Perioperative nursing is experiencing greater shortages than any other specialty and has been largely removed from undergraduate education. This DNP quality improvement project aimed to impact the recruitment of perioperative nurses through undergraduate nursing clinical exposure and experience. The project addressed the lack of clinical nursing student opportunities in the perioperative department at the partner site to increase interest in perioperative nursing and recruit core staff nurses from the pool of new graduates. Kotter’s Eight-Step Change Model and the Social Career Cognitive Theory framed the project’s design and implementation for two cycles, between January and March 2024 and 2025. Using …

Strengthening Communication Between Staff And Health Providers In A Mental Health Setting, Michael Tricoli

Doctoral Dissertations and Projects

Communication between nursing staff and providers is essential for supporting optimum patient outcomes. Each component of the communication process needs to be clearly defined to create an environment of safety for both patients and caregivers. The SBAR (situation, background, assessment, recommendation) is a nurse-driven protocol that is widely used as a communication and documentation template in health care organizations. This format is currently not being used effectively on the mental health units where the evidence-based project was implemented. Recognizing and reiterating the value of SBAR as a communication tool is necessary when communication deficits are noted. The purpose and scope …

Optimising Healthcare Delivery: Efficiency Analysis Of Oman’S Governorate Hospital Networks, Sultana M. Al-Sabahi, Avinash D. Pinto, Qasem Al-Salmi, Hilal A. Al-Sabti

Sultan Qaboos University Medical Journal

Objectives: This study aimed to evaluate the efficiency of the healthcare facilities in the Oman to guide the decision-making process and benchmarking. Methods: Input-oriented data envelopment analysis (DEA) was used to assess the relative efficiency of governorate hospitals in Oman using 2022 data extracted in December 2023. In the second stage of data analysis, the Tobit model was applied to assess determinants of governorate hospital inefficiency; 3 DEA models were created (staffing, structure and budget). Results: A total of 10 governorate hospitals were included in this study. The efficiency score change was small for the governorate hospitals …

Transformative Integration: Navigating Opportunities And Challenges In A Medical School's Evolution Into Integrated Service Units, Chelsea Chang, Everardo Cobos, Michael Sander, Beatriz Tapia, Michael Hocker

School of Medicine Publications

Medical schools must evolve with the changing healthcare landscape and financial pressures. Academic Health Centers have responded to these changes with a novel organizational model known as an integrated service line. Traditional medical school departments often create silos, lack of alignment, and financial burdens. To our knowledge, we were the first medical school to implement an integrated structure combining the tripartite missions of academics, research, and clinical services.

The University of Texas Rio Grande Valley School of Medicine accepted its charter class of 55 medical students in 2016 with a traditional medical school department model. By 2023, it had 154 …

The Effects Of In-Depth Exposure To The Lived Experience Of Aphasia On Student Learning, Brianne Roos, Gretchen Szabo, Tami Brancamp, Elizabeth Hoover, Chaleece Sandberg, Tom W. Sather

Teaching and Learning in Communication Sciences & Disorders

Although individuals with aphasia are commonly treated by speech-language pathologists, many clinicians entering the field feel under-prepared to work with this population. Undergraduate and graduate students need appropriate training that emphasizes person-centered care mapped onto evidence-based practice, combining high-quality research evidence, clinical expertise, and client preferences. Incorporating lived experience into curricula helps shape students’ knowledge and understanding of aphasia from the perspective of patients and carepartners. Using both quantitative and qualitative methods, this study examined the impact of in-depth exposure to the lived experience of aphasia on students across six US universities. Students read the book Identity Theft: Rediscovering Ourselves …

The Burden Of Burnout: Understanding Its Prevalence And Organizational Drivers In Medical Physics, Deborah Schofield, C Lynn Chevalier, Laurence Court, William Harmsen, Akiva Turner

Faculty, Staff and Student Publications

Background: Burnout is a work-related syndrome characterized by increased levels of emotional exhaustion (EE) and depersonalization (DP) along with decreased levels of personal achievement. In the healthcare setting, higher burnout levels have been associated with negative impacts on personnel, an increased risk of errors, and a decrease in the quality of delivered care.

Purpose: The purpose of this study was to assess the prevalence of burnout among medical physicists working in the United States. Additionally, the impact of personal and organizational features on burnout risk was examined.

Methods: The anonymous survey was distributed to 1962 full members of the American …