Digital Commons Network^™

Improving Alcoholism Treatment Through Adverse Childhood Events Score Education, Miranda Cobenais

Walden Dissertations and Doctoral Studies

Summary I conducted this Doctor of Nursing Practice (DNP) staff education project to improve knowledge and clinical practice among mental health professionals. The problem identified at the project site was the limited awareness and use of Adverse Childhood Events (ACE) assessments in treating alcoholism. The practice focused question for this project was: Will educating staff on how ACE scores can improve treatment of alcoholism increase staff knowledge regarding the importance of assessing ACE scores to decrease relapse rates? The purpose of this doctoral project was to evaluate if an educational intervention can enhance staff understanding of the connection between ACEs …

“It Seems Like A Never-Ending Job”: Voices Of Female Caregivers Of Older Adults In The Rural Communities, Lalani Nasreen, Bhagyashree Katare, Evans Appiah Osei, Siqi Yang, Sampada Wagle, Julian L. Gallegos, Abidemi Mary Ajuwon

School of Nursing Faculty Publications

Background: Rural female caregivers of older adults face significant caregiving challenges that puts them at high risk for poor self-care and wellbeing. Limited studies have examined the self-care needs of caregivers from a gender equity and social perspective.

Objective: Our study aims to explore the self-care needs and preferences of rural female caregivers and underlying key processes contributing toward their health and well-being. Methods: A qualitative descriptive design was used for the study. A purposive sample of (n = 20) rural female caregivers was obtained. In-depth individual interviews were conducted for data collection. Each interview was about 45- 60 min …

Falls Prevention In A Psychiatric Setting, Albert Koroma

Walden Dissertations and Doctoral Studies

The project is a staff education initiative designed to improve the knowledge of psychiatric mental health clinicians regarding fall prevention. The gap in practice was the staff’s knowledge deficit in fall prevention. The staff’s knowledge deficits result in inconsistent prevention strategies. The practice-focused question guiding the project was: Among psychiatric mental health clinicians, does participation in an evidence-based fall prevention education program increase knowledge of fall prevention strategies as compared to pre- to post-education? The purpose of the project was to improve clinician knowledge of psychiatric-specific fall risks and evidence-based prevention strategies. The analytical strategies utilized in the project included …

The Relationship Between The Health Science Reasoning Test And Successful Completion Of An Associate Degree Nursing Program: A Retrospective Predictive Study, Joyce A.Ajkuce Kucerovy

Doctoral Dissertations and Projects

The purpose of this study was to retrospectively identify whether the addition of an entrance exam such as the Health Science Reasoning Test (HSRT) to the current admission criteria of an associate degree nursing (ADN) education program would aid in selecting students with the highest chance of successfully completing the program and entering the workforce. A nonexperimental, retrospective, quantitative, predictive correlational study design was used. A retrospective convenience sample of 320 first-year nursing students in an ADN education program was obtained. The G* power analysis showed a minimum sample size of 107 students was needed. Statistical analysis involved a multiple …

Treatment For Women With Mental Health Disorders Associated With Reproductive Health: An Opportunity For Interprofessional Collaboration, Ellen Modlin Phd, Otr/L, Bcp, Caps, Deana Goldin Phd, Dnp, Arnp, Fnp-Bc, Pmhnp-Bc

Journal of Interprofessional Practice and Collaboration

Abstract

Purpose: This article proposes an opportunity for interprofessional collaboration between mental health practitioners (MHPs) and occupational therapy practitioners (OTPs) for the treatment of women experiencing mental health disorders (MHDs) associated with reproductive health (RH) changes throughout the lifespan. This collaborative approach have the potential to optimize women’s health care and mitigate the risk of fragmented care, as these conditions are highly complex.

Method: Peer- reviewed literature from mental health and occupational therapy (OT) research was reviewed and summarized. The search focused on the barriers and potential opportunities for collaboration between MHPs and OTPs in women affected with MHDs associated …

Impact Of Dialysis On Medication Pharmacokinetics, Rachel Marie Bounds

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education initiative to improve nurses’ knowledge and comfort with dialysis-specific medication management. The project addressed a practice gap in which nurses at the clinical site had limited knowledge of medication administration for patients with end-stage renal disease. These patients have altered pharmacokinetics and high medication burden, which increases the risk of adverse drug events. Inappropriate management of medications during dialysis can lead to hypotension, ineffective treatment, and glucose instability, making this a critical nursing practice issue. The project answered the practice-focused question of whether a structured educational intervention would improve nurses’ knowledge and comfort …

Development Of An Educational Intervention To Enhance Nurses’ Knowledge And Intent To Implement Evidence-Based Diabetes Self-Management In Clinical Practice, Anne Marie Sieyou Ngouane

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was purposed with closing critical gaps in staff knowledge and adherence to diabetes self-management protocols in a busy primary care clinic. Rising readmission rates and uneven use of American Diabetes Association (ADA) standards signaled an urgent need for a structured approach to staff education. To address this, a one-hour interactive training session was created that blended teaching, evidence-based handouts, and a practical diabetes care checklist. Staff learning was measured through pretest and posttest, confidence and adherence used a 5-point Likert-scale survey, and 21day readmission data tracked patient outcomes. The project question asked if …

Enhancing Anxiety Identification In Adult Patients, Wonda Crump

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing (DNP) project, I focused on implementing a staff education program for anxiety screening at a health and wellness clinic. Mental health conditions, particularly anxiety disorders, are common in primary care settings. Research shows that anxiety affects millions of adults, yet many cases remain undiagnosed. The practice problem that I identified was that many patients with anxiety disorders were going undiagnosed during regular clinic visits. The clinic had no standard process for screening anxiety, and staff members had a knowledge deficit on the proper use of anxiety assessment tools. This gap in practice led to missed …

Staff Education To Enhance Provider Knowledge On Lifestyle Modification For Hypertension Management, Chinyere Maria Assumpta Ofoegbu

Walden Dissertations and Doctoral Studies

Summary A doctor of nursing practice (DNP) staff education project was designed to enhance healthcare providers' knowledge of lifestyle interventions for hypertension management. At the practice site, primary healthcare providers were not regularly integrating lifestyle counseling. The practice-focused question guiding this project was: In primary care providers, how does implementing an evidence-based lifestyle education training program for hypertension management affect provider knowledge? An in-person educational session was provided to ten (10) healthcare practitioners who voluntarily participated. Pre- and post-training knowledge assessments was the analytical techniques employed to examine changes in provider comprehension of lifestyle-based hypertension care. Descriptive statistics and paired-sample …

Multidisciplinary Approach To Reducing Healthcare-Associated Infections: A Dnp Project, Jovinsky Jonaldo Eliscard

Walden Dissertations and Doctoral Studies

Healthcare-associated infections are increasingly common in healthcare facilities due to multiple concerns, including negligence, human error, and poor conditions. According to Chuwa (2024), secondary infections are a significant threat to patient safety and wellness, reducing an organization’s ability to realize clinical objectives. The facility is a large healthcare provider operating numerous hospitals and care homes across the United States. The organization continues to report increased infection rates across its branches owing to a lack of standardized infection prevention and control protocols, reducing its efficiency and appeal. Internal audits point to inconsistencies in general sanitation, cleanliness, and hygiene. The organization also …

Eeg Pressure Injuries, Paula Ebert

Nursing Grand Rounds

EEG Pressure Injuries. Paula Ebert, MS, RN, CNS, ACCNS-AG, CCRN, SCRN

Objectives:

• Understand the clinical impact of pressure injuries related to EEG
• Understand the implemented changes to reduce pressure injuries related to EEG
• Understand the multidisciplinary approach to addressing the problem

Staff Education To Improve Patient Safety Using Standardized Medication Transcription Verification, Beloved Martey

Walden Dissertations and Doctoral Studies

This staff education project was a quality improvement initiative aimed at reducing medication transcription errors by implementing a standardized verification protocol. The project addressed the critical practice problem of transcription-related medication errors, which contribute to wrong medication administration, adverse drug events, and patient harm. The practice-focused question was: How does implementing a staff education program on standardized medication transcription verification processes in healthcare institutions affect the rate of wrong medication administration compared to traditional transcription methods without education? The project was implemented over 8 weeks in an outpatient clinic with 20 participants (8 prescribers and 12 nurses). The primary data …

Staff Education Project For Nursing Staff At An Adult Mental Health Clinic To Address Inconsistencies And Inadequacies In Suicide Risk Screening, Grace Oluwasade Awodele

Walden Dissertations and Doctoral Studies

This staff education initiative was designed for nursing personnel at an adult mental health clinic, aiming to address inconsistencies and inadequacies in suicide risk screening practices among health care providers. Despite regular patient interactions, staff frequently lack the necessary knowledge, confidence, and standardized tools to identify individuals at risk for suicide, leading to missed opportunities for early intervention. The existing gap in practice jeopardized patient safety, led to preventable harm, and highlighted the need for evidence-based screening protocols, such as the Ask Suicide-Screening Questions (ASQ) tool, to facilitate timely, equitable, and effective suicide prevention in nursing practice. The project focused …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Prevalence Of Sexual Harassment Among Nurses And Nursing Students In A Culturally Conservative Country, Hanadi Mohamad Nur Steitiyeh, Fatin Ahmad Safa, Jana Daoud Al Hajj Daoud, Adam Tarek Ikkawi, Sahed Ali Fawaz, Hiba Deek

BAU Journal - Science and Technology

The prevalence of sexual harassment among nurses and nursing students in Lebanon is an unidentified social concern. This study aims to identify this prevalence and assess the related factors. Using a self-administered questionnaire the sociodemographic characteristics, workplace variables, physical appearance, and the Sexual Experience Questionnaire (SEQ) were assessed, the data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A total of 380 participated with 71.8% being female and 63.9% aged between 18 and 25. Sexual harassment was experienced by 91 participants (23.9%) and occurred mainly in the patients’ rooms and during procedures. Policies were absent or …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

Tiny Heart Bundle Qi Project: 3d Modeling To Improve Care Of Cardiac Nicu Patients, Stacy Ranee Harris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background—Infants with congenital heart disease (CHD) are being care for in the neonatal intensive care unit (NICU) by increasing numbers of novice nurses. Understanding complex cardiac anatomy is imperative to novice nurses’ readiness to care. Parents of infants with CHD may not understand their child’s anatomy, which impacts many facets of their care.

Purpose— The purpose of this quality improvement (QI) project was to determine if education, including 3D heart models improved novice nurse readiness to care for NICU patients with CHD and if parental understanding improves after receiving education with 3D heart models.

Methods— This was a plan-do-study-act (PDSA) …

The Impact Of Nurse-Led Distraction Techniques On Pain And Anxiety During Cancer Treatment In Pediatric Oncology Patients: Examining Virtual Reality And Play Therapy, Alexis Abalos

Nursing | Senior Theses

Children undergoing cancer treatment often experience pain and anxiety during cancer treatment, including chemotherapeutic invasive procedures such as frequent port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce levels of pain and anxiety in pediatric oncology patients. This thesis analyzes existing data through a close examination of primary and secondary research articles that prove the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. Using the University of California, San Francisco (UCSF) Symptom Management Theory, …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

How Instructor Engagement Shapes Nursing Students’ Perceptions And Specialty Preference, Marissa M. Sigel

Nursing | Senior Theses

Background: As nursing students approach graduation, choosing a specialty becomes a key decision. Although clinical rotations offer exposure to different practice areas, the role of the clinical instructor is equally influential. Instructor engagement extends beyond teaching skills and may shape how students perceive clinical environments. Objective: This study examines how clinical instructor engagement influences senior nursing students’ specialty preferences. Method: A longitudinal cohort design will be used with pre-licensure BSN students at a small private university in Northern California. Students will complete the same survey twice during their program, and paired t-tests will be used to assess changes in specialty …

The Relationship Between Registered Nurse Burnout, Organizational Engagement, And Quality Outcomes In Acute Care Hospitals, James E. Parsons

Theses, Dissertations and Capstones

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care …

The Prediction Of All-Cause Mortality In End-Stage Kidney Disease Patients Using Social Determinants Of Health: A Machine Learning Framework, Addy Smith, Maxwell Donelan, Hossein Moradi Rekabdarkolaee, Patti Brooks, Brandon Varilek, Surachat Ngorsuraches, Jerry Schrier, Adam Dell, Semhar Michael

Journal Articles: College of Nursing

End-stage kidney disease (ESKD) is the irreversible final stage of chronic kidney disease in which the kidneys lose their independent function. This study presents a machine learning framework to predict all-cause mortality in ESKD patients by the end of a follow-up period. We combined patient-specific clinical factors with social determinants of health (SDOH) to assess their influence on survival outcomes. Data were obtained from the United States Renal Data System, including patients admitted in 2015 and followed through August 2021. Community-level SDOH data were integrated from the Agency for Healthcare Research and Quality, with variable screening techniques and expert input …

Enhancing Stroke Recovery: A Proposal To Implement Self-Efficacy Strategies In Rehabilitation, Ariana M. Allen, Elliott P. Mcneely

Williams Honors College, Honors Research Projects

Self-efficacy is a critical predictor of rehabilitation success in stroke survivors, influencing motivation, therapy adherence, and functional recovery. This study will investigate the current use of structured self-efficacy enhancement programs (SEEPs) by healthcare professionals in post-stroke rehabilitation settings. Guided by Bandura's Self-Efficacy Theory, this proposal outlines a study that will include a comprehensive literature review and suggestions for further research. It will explore the frequency and methods of SEEP use, including goal setting, motivational feedback, and graded task planning. Data would be analyzed through descriptive statistics and thematic analysis. Findings are expected to identify usage patterns, barriers, and opportunities to …

Routine Guided Meditation In Nicu Nurses: A Coping Strategy For Nicu Nurses Dealing With Newborn Deaths, Gianna Wong

Nursing | Student Research Posters

Purpose: This research study aims to investigate the emotional impact of newborn deaths on Neonatal Intensive Care Unit (NICU) nurses in addition to evaluating their perceptions of routine guided meditation as an effective coping mechanism to manage professional grief and enhance psychological well-being. Methods: Utilizing an exploratory descriptive research design grounded in Pender’s Health Promotion Model (HPM), this study examines the lived experiences and health-promoting behaviors of neonatal nurses following newborn deaths. Data: Anticipatory collection of data will be from a sample of NICU nurses based in California through a twelve-question survey featuring open-ended questions. Qualitative content …

Radiation Therapy Without Anesthesia For A 7-Month-Old Child Using Audio-Visual Assisted Therapeutic Ambience In Radiation Therapy (Avatar), Johnathan Muddle

Faculty Publications - College of Nursing

Radiation therapy (RT) plays a crucial role in the treatment of many childhood cancers. Precise delivery of RT is important for minimizing dose to critical structures and reducing late toxicity. However, young children often struggle with the need to remain still in the treatment room for sessions lasting up to 45 minutes, leading to frequent use of daily anesthesia over the treatment course. Though anesthesia utilization rates vary, up to 50% of children aged 7 to 8 are reported to require anesthesia during treatment, with rates potentially higher in limited settings.