Digital Commons Network^™

Enhancing Nursing Self-Efficacy In Advance Care Planning Conversations Through Role-Play Education: A Quality Improvement Project, Rachel Williams

DNP Projects

Background:
Advance care planning (ACP) conversations are essential for ensuring that patient healthcare preferences are understood and respected; however, nurses often report limited confidence and self-efficacy when initiating these discussions. Educational interventions that emphasize communication skills may improve nurses' preparedness to engage in ACP conversations.

Methods:
A quality improvement project utilizing a pre-post intervention design was conducted on three adult inpatient medical units within a regional Midwestern hospital. Registered nurses participated in an educational intervention consisting of ACP education, role-playing case scenarios, guided discussion, and debriefing. A modified 22-item Advance Care Planning Self-Efficacy Questionnaire was administered before and after the …

Dnp Final Report: Improving Rehospitalization Rates And Caregiver Quality Of Life In Outpatient Hospice, Carrie M. Judd

DNP Final Reports

Background: Hospital readmissions among home hospice patients disrupt continuity of care, increase healthcare costs, and may compromise end-of-life preferences.

Purpose: This quality improvement project evaluated the feasibility of implementing a telehealth communication intervention in an outpatient hospice organization. Project aims were to reduce Type I live hospice discharges by at least 2.5% and improve caregiver quality of life (QOL).

Methods: Zoom for Healthcare® video visits and three-way telephone communication supplemented standard nurse practitioner hospice visits during a three-month implementation period. Type I live discharge rates were compared with the organization's baseline quality metrics. Caregiver QOL was measured pre- and post-intervention …

Standardizing Neurological Assessments, Delaney Miller, Hannah Dorsey, Lauren Sulzen, Olivia Garrett, Patricia Rios, Sukhmanpareet Kaur

2025

No abstract provided.

Dnp Final Report: Improving Length Of Stay Outcomes Using Structured Barrier Rounds: A Quality Improvement Project, Martha Kwamboka Apella

DNP Final Reports

Prolonged length of stay (LOS) in the acute care setting is a challenging issue driven by multiple factors. Increased LOS is associated with mortality, hospital-acquired infections, patient safety events, functional impairment, decreased quality of life, social isolation, and increased cost of care. The causes of increased LOS in the medical-surgical unit are unclear, necessitating an evidence-based project to address the problem. The purpose of this quality improvement initiative was to implement structured interdisciplinary barrier rounds and evaluate their effect on LOS, opportunity days, and estimated cost of care in a medical-surgical unit. The facility complex care coordinator (CCC) was identified …

Dnp Final Report: Enhancing Self-Regulated Learning And Metacognition For First-Semester Undergraduate Nursing Students, Carla S. Biondillo

DNP Final Reports

Background. First-year undergraduate nursing students often struggle to adapt their learning strategies to the higher-order thinking and clinical reasoning demands of nursing education. Ineffective study habits, low academic self-efficacy, and limited self-regulated learning (SRL) skills are consistently identified as predictors of attrition, which ranges from 20–50% nationally and internationally.

Purpose. At an academic medical center in rural East Texas, first-semester students report academic overwhelm and inadequate study strategies, consistent with national trends. A structured, evidence-based faculty coaching intervention targeting SRL and metacognition was found to be feasible within the collaborative, student-centered organizational culture.

Methods. A quality improvement (QI) design …

Dnp Final Report: Community-Based Advance Care Planning Education For Older Adults: A Quality Improvement Project, Teresa Hill

DNP Final Reports

Background: Advance care planning (ACP) supports patient autonomy and promotes care aligned with individual values and preferences. Despite these benefits, fewer than half of adults aged 50–80 have completed formal ACP documentation, and community-dwelling older adults rarely engage in ACP before serious illness, representing a persistent gap in early engagement.

Purpose: This quality improvement (QI) project evaluated the effectiveness of a community-based ACP educational intervention in improving ACP knowledge, confidence, and engagement among older adults.

Methods: A nurse facilitator trained in the Five Wishes framework delivered a structured, 60-minute ACP workshop at a senior center in North Texas. A pre–post …

Snap Into Better Pediatric Neuro Assessments, Irene Chacko, Nayelli Fuentes, Annie Mazon Kellejian, Claire Ring, Ibrahim Shaikh

2025

No abstract provided.

Enhancing Staff Knowledge Of Prenatal Depression Screening And Follow-Up Protocols, Gladys Ajohmbu Esunji

Walden Dissertations and Doctoral Studies

This staff education project addressed inconsistent staff knowledge of prenatal depression screening and follow-up protocols in an outpatient behavioral health practice serving prenatal patients. Prenatal depression is a nursing practice concern because delayed identification and inconsistent follow-up may affect maternal well-being, infant outcomes, family functioning, and timely access to behavioral health support. The practice-focused question was: According to the evidence, among clinical staff in an outpatient maternal mental health setting, what is the impact of structured staff education on adherence to prenatal depression screening on follow-up protocol knowledge? The purpose was to improve clinical staff knowledge through a structured education …

Proposal For A Comprehensive Workplace Violence Program In An Acute Care Facility, Christin V. Timmons

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) in healthcare is a growing threat to caregiver safety, workforce stability, and patient outcomes. At a newly opened acute care facility, the absence of a comprehensive WPV prevention program posed a gap in practice, creating safety risks and regulatory vulnerability. A literature search was conducted using CINAHL, PubMed/ MEDLINE, ProQuest Nursing & Allied Health collection, and Google Scholar. A total of 50 articles were identified with 11 articles meeting all inclusion criteria. Collectively, findings supported comprehensive, multicomponent WPV prevention programs to integrate leadership engagement, structured governance, staff education, environmental controls, and continuous data monitoring to improve safety …

Pit Stop: Improving Resuscitation Efforts Within A Level Iv Nicu, Sierra Pharr, Kendall Shaw, Hannah Biscardi

2025

No abstract provided.

A Program Proposal For A Leadership-Driven, Evidence-Based, Intentional Rounding Playbook, Jacqueline Butler Brown

Walden Dissertations and Doctoral Studies

Patient experience is a key indicator of healthcare quality. In an acute care hospital in Northeast Georgia, intentional rounding is an established practice. Inconsistent communication, variable leadership engagement, and limited accountability are practice gaps that have reduced its effectiveness in improving patient experience outcomes. A comprehensive literature review using PubMed, CINAHL, MEDLINE, and the Cochrane Library yielded 15 peer-reviewed studies that consistently support intentional rounding as an evidence-based strategy for improving patient satisfaction. As the team leader for this Executive Leadership System Improvement Project, I proposed the development of an Evidence-Based, Leader-Driven Intentional Rounding Program Playbook to standardize enhanced rounding …

Exploring The Motivations And Educational Needs For Undergraduate Nursing Students To Enter Into Critical Care: A Qualitative Study., Christina S. Pradhan

Doctoral Dissertations and Projects

Critical care nursing is a specialty that demands a high level of skill and dedication. In this high-stress, fast-paced environment, nurses must think fast and act decisively with sound clinical judgment and knowledge. The purpose of this hermeneutic phenomenological qualitative study was to understand the motivating factors that cause nurses to enter the field of critical care, as well as to explore the ways in which undergraduate nursing studies may be improved to better prepare future critical care nurses. Knowles’ adult learning theory was well suited for nursing students bound for a critical care path. Students at two different baccalaureate …

Pedagogy Challenged: A Phenomenological Examination Of Teaching Through A Prolonged Technological Disruption, Jerry Cervantes

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to examine the lived experiences of nursing faculty in a pre-licensure Bachelor of Science in Nursing program who taught during a prolonged technological disruption caused by a ransomware attack at a private college in Ohio. The theories guiding this study were transformative learning theory and resilience theory as they relate to how educators make meaning of disorienting events and sustain professional functioning when established systems fail. Data were collected through semi-structured interviews, a focus group, and reflective journals from purposively selected nursing faculty participants and were analyzed according to the phenomenological procedures …

Understanding The Experience Of Separation On The Substance-Exposed Mother-Infant Dyad, Tamara Lee Depascale

Electronic Theses and Dissertations 2020 - Present

Maternal-infant separation following birth is a profoundly distressing experience that may have significant emotional, relational, and health implications for mothers with substance use disorders (SUD). Guided by Caring Science and Swanson’s Theory of Caring, the purpose of this qualitative descriptive study was to explore the dimensions of the health challenge associated with maternal-infant separation among mothers with SUD following birth and the approaches mothers used to navigate and respond to that experience. Data were collected through semi structured interviews with mothers who had experienced separation from their infants following birth and analyzed using deductive and inductive thematic analysis. Findings revealed …

Exploring Nursing Students' Experiences Of Simulation-Based Learning In Developing Critical Thinking, Clinical Reasoning And Clinical Judgment In The Management Of Mental Health Patients: A Qualitative Case Study, Irene Bellew

Doctoral Dissertations and Projects

The purpose of this case study was to explore how simulation-based learning experiences shape the development of critical thinking, clinical reasoning, and clinical judgment for associate degree nursing students when caring for patients with mental health needs. It addressed the need to narrow the gap between theoretical knowledge and practical application in clinical settings, enhancing the preparedness of novice nurses. By positioning nurse educators as facilitators of innovative strategies, this study advocates for the integration of simulation-based learning within nursing curricula. Roy’s adaptation model guided the study, and data were collected through observation of simulation sessions, semi-structured interviews, and reflective …

Uncovering The Path To Diagnosis Among Adults With Attention-Deficit/Hyperactivity Disorder: A Constructivist Grounded Theory Mini-Study, Jeffrey D. Whitaker, Rick Zoucha, Melissa Kalarchian

Graduate Student Research Symposium

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical …

Exploring Academic–Practice Partnerships In Community Settings: A Narrative Review, Laura C. Sarver

College of Nursing Faculty Papers & Presentations

Purpose: This narrative review explored the literature on academic–practice partnerships in community settings within prelicensure nursing education. Methods: A search of three databases—MEDLINE, CINAHL, and Scopus—led to the review of 12 articles exploring academic–practice partnerships in community settings within prelicensure nursing education. Results: Emergent themes encompassed components for planning, implementing, and evaluating academic–practice partnerships. Planning themes included completing community assessments, considering financial resources, and identifying guiding frameworks or models. Implementation themes included diverse nursing education and community partners and settings, academic–practice partnership initiatives, and integration of partnerships in prelicensure nursing education curricula. Lastly, evaluation themes included the exploration of a …

Let Us Get To Know You, Libby Pearl, Abigail Rubio, Anna Wiot, Elizabeth Richmond, Jocelyn Jasso, Nayeli Barajas, Maliha Rahman

2025

No abstract provided.

Continuous 1:1 Sitter Observation Versus Standard Safety Interventions To Reduce Falls In Hospitalized Adults At Risk, Zainab Williams

Student Scholarly Projects

Practice Problem: Patient falls remain a significant patient safety concern among hospitalized adults, particularly those at high risk. Traditional fall-prevention strategies, including continuous 1:1 sitter observation, require evaluation to determine their effectiveness in reducing falls and fall-related injuries.

PICOT: In hospitalized adult patients at high risk for falls (P), does continuous 1:1 sitter observation (I), compared to standard safety interventions (C), reduce fall rates (O) as measured by reported falls per 1,000 patient days during hospitalization over 12 weeks (T)?

Evidence: Current evidence supports multifactorial fall-prevention programs that combine patient assessment, staff engagement, and proactive nursing interventions through intentional rounding. …

Staff Education To Decrease Workplace Violence Through De-Escalation Training In The Emergency Department, Tyrani Anderson

Walden Dissertations and Doctoral Studies

Workplace violence remains a significant issue in healthcare settings, particularly in emergency departments where psychiatric patients may present with aggressive behaviors. Nurses and healthcare staff are frequently exposed to verbal threats, intimidation, and physical aggression, which negatively impact staff safety, job satisfaction, and patient care quality. Despite workplace violence prevention policies, gaps remain in staff preparedness when managing escalating patient behaviors. The purpose of this Doctor of Nursing Practice project was to implement an evidence-based de-escalation training program to improve staff knowledge about managing aggressive psychiatric patients in the emergency department. The practice- focused question was: Can staff education on …

Examination Of Maternal Mortality, Mental Health Conditions, And Co-Occurring Factors, Laura Eileen Skaarer

Walden Dissertations and Doctoral Studies

Maternal mortality (MM) continues to be a public health concern in the state of Arizona. There is little to no research investigating the relationship between MM and mental health conditions co-occurring with contributing factors among women who have died in Arizona while pregnant or within 1 year of the end of a pregnancy. The purposes of this quantitative study, guided by the three delays model (3DM), were to examine (a) MM and mental health conditions as the primary underlying cause of death; (b) MM and mental health conditions surrounding death; and (c) significant contributing factors (i.e., discrimination, knowledge, lack of …

A Charism-Based Faculty Instruction Framework For Nursing Education: Integrating Values-Driven Pedagogy In Blended Learning Environments, Humprey G. Icban, Anele C. Mallari, Cherry B. Lazatin, Aurora R. Valencia, Lilibeth G. Sales, Ulysses J. Rengel, Marie Aileen L. Domingo

The Journal of Faith, Education, and Community

The evolution of nursing education in the Philippines is driven by dynamic global healthcare demands and an accelerated shift toward blended learning modalities. The central challenge lies in preserving the humanistic values of compassion and integrity within technology-mediated environments. This study addresses this issue by developing a Charism-Based Faculty Instruction Framework (CBFIF) designed to empower clinical instructors at the University of the Assumption College of Nursing and Pharmacy (UACONP) in their crucial role as "Formators of Catholic Leaders." The framework is intended to cultivate the institution's core graduate attributes: "Biasa" (academically competent), "Maganaca" (morally upright), and "Mayap" (socially responsible). A …

Different Minds, Same Great Care: Effects Of Specialized Care Plans On Patient Satisfaction, Danielle Castillo, Sarah Aguilar

2025

No abstract provided.

Staff Education To Instruct Nurses On How To Use The Braden Scale To Increase Their Knowledge, Anna Shedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

Enhancing Nursing Competency In The Ambulatory Surgery Center, Rachael Owokole

Walden Dissertations and Doctoral Studies

In this project, I addressed a persistent practice problem among agency nurses working in an ambulatory surgery center (ASC) in Southern California, who often enter the facility with varying familiarity with its policies and procedures. I designed this staff education, evidence-based practice (EBP), quality-improvement initiative to strengthen nursing knowledge and competency among agency nurses at the facility. The practice question was designed to assess on whether their knowledge and self-perceived competency improved after participating in the education program. I obtained evidence for the project from peer‑reviewed research, clinical guidelines, and national competency frameworks. I identified sources through systematic searches of …

Improving Patient And Staff Safety During Intrahospital Transport: Implementation Of A Nurse-Driven Checklist, Leah D. Kvintus Rn, Bsn

Nurse Residency

In hospitalized adult patients requiring intrahospital transport, how does the implementation of a standardized nurse-driven transport checklist and structured, facility-wide transport safety protocols compared to current practice without standardization affect patient and staff safety outcomes, including patient falls, safety incidents, and staff injuries or workflow disruption?

Fall Prevention Education Among Older Adults At Townson Assisted Living Facility (Talf), Yolana Farrell-Williams

Walden Dissertations and Doctoral Studies

Falls in the elderly are a significant cause of injury, disability, and preventable medical expenditure; thus, fall prevention is an issue to assisted living homes like Townson Assisted Living Facility (TALF). The internal incident reports showed that persistent fall incidents were associated with inconsistent knowledge among the staff and unequal observed compliance with fall-prevention guidelines, indicating a practice gap in the systematized education of nurses. Educational interventions are effective in achieving high-quality staff, adherence to protocols, and outcomes concerning falls. Consequently, the current project was conducted to determine whether a specialized falls-prevention education program would enhance the knowledge and competency …

Effect Of Virtual Reality Intervention Of Postoperative Pain In Pediatric Surgical Patients, Tara L. Kempker

Dissertations

Problem: Pediatric surgical procedures are associated with preoperative anxiety. Preoperative anxiety is associated with higher postoperative pain. Multiple studies have found that decreasing preoperative anxiety using Virtual Reality (VR) Intervention also decreases postoperative pain scores and use of rescue analgesics in postoperative care units (PACU). However, there is no standardized protocol for use of VR interventions and in our institution, VR was not utilized at all.

Methods: This quality improvement (QI) initiative utilized a quasi-experimental design and convenience sampling. Quantitative data was collected during visits for scheduled operative visits for pediatric surgical patients ages seven to 18 years …

Psychotropic Medication Use In Older Adults In A Long-Term Care Facility: Implications For Screening Tool, Callie M. Johnson

Dissertations

Psychotropic medication use in older adults aged 65 years and older residing in the long-term care facility has a complex issue in the high use of psychotropic medications. Older adults residing  in long-term care (LTC) facilities are affected and prescribed at least one psychotropic or antidepressant medication.

Enhancing Well-Being: Implementing Weekly Social Interventions For Older Adults In Independent Living, Rosa Huang

Dissertations

Loneliness and social isolation significantly impact the physical and mental well-being of older adults. This quality improvement project implemented an eight-week social intervention designed to reduce loneliness and enhance well-being through weekly sessions incorporating mindfulness exercises, gratitude journaling, and structured socialization activities. The intervention was delivered by nursing students to a sample of residents in a Midwestern independent living community. While most standardized measures of loneliness and mood did not show statistically significant changes, the project resulted in a statistically significant increase in social network engagement as measured by the Lubben Social Network Scale-6 (LSNS-6). The findings suggest that group-based …