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You Haven’T Been Forgotten: Driving Improvements In Trust, Transparency, And Accountability Through A Patient-Centered Communication Initiative In The Emergency Department, Ellie Mead

Master's Projects and Capstones

Objective: In Spring 2026, the Emergency Department (ED) at Hospital X identified difficulties securing high levels of patient satisfaction. Over one third of patients did not feel adequately “informed about delays,” and observation of nurse-patient interactions in front-end care areas confirmed these communication gaps: in 87% of interactions, nurses did not explain next steps to the patient, and in none of the 51 interactions observed did nurses proactively inform patients about possible delays. Aim: This quality improvement initiative sought to improve the patient experience in the ED and drive a 10% increase in Press Ganey patient satisfaction survey results relating …

Staff Education To Improve Staff Knowledge On Fall Prevention, Nginjoh Presilia Njofang

Walden Dissertations and Doctoral Studies

Patient safety risks associated with falls are a major issue in adult inpatient medical-surgical environments because nursing inconsistencies with regard to fall risk assessments, individualized fall prevention interventions, and documentation could impede adherence to best practices. To overcome this knowledge gap among RNs in the selected environment, a DNP education project aimed at standardized fall-prevention staff education was initiated. The question for the practice was whether standardized staff education would increase knowledge among nurses regarding fall-risk assessments, preventive measures, and documentation requirements, based on pretest and posttest results. In the course of a one-hour educational session conducted face-to-face, twenty RNs …

Implementation Of A Nurse-Led Self-Measured Blood Pressure Program In Rural Primary Care, Stephanie Marie Montgomery

Walden Dissertations and Doctoral Studies

Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality, yet blood pressure control remains suboptimal among many adults, particularly those receiving care in rural primary care settings. Reliance on office-based blood pressure measurements may limit opportunities to identify uncontrolled hypertension and actively engage patients in disease self-management. This Doctor of Nursing Practice quality improvement project evaluated the implementation of a standardized self-measured blood pressure (SMBP) program for adult patients with hypertension in a rural primary care practice. The intervention included validated home blood pressure monitors, standardized patient education, teach-back to verify measurement competency, structured home blood pressure …

Addressing Food Insecurities Through Staff Education In The Rural Health Setting, Angela Dawn Suttle

Walden Dissertations and Doctoral Studies

Rural America, including Arkansans, face a number of social determinants of health (SDOH) including food insecurities (FIs) and the inability to access nutritious food. FIs contribute to poor outcomes and increases healthcare utilization. Inconsistent screenings for FIs in adults living in the rural health clinic (RHC) setting, lack of standardized workflows, and failure to provide community resources when FI is identified represents a significant gap in practice. Purpose: The purpose of this Doctor of Nursing Practice (DNP) staff education project was to increase utilization of screening tools for FI, implement a standardized workflow, and provide patients with resources to improve …

Staff Education To Improve Early Identification Of Behavioral Escalation And Timely Clinical Intervention In An Adult Group Home Setting, Gayduo Barr

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project addressed a gap in staff knowledge regarding the early identification of behavioral escalation and timely intervention in an adult group home setting. The practice-focused question was: Does staff education about early identification of behavioral escalation and timely clinical intervention improve the knowledge of staff working in an adult group home setting? The purpose was to improve staff knowledge of behavioral escalation, triggers, trauma-informed care, and intervention strategies. I delivered a structured educational intervention to 14 house managers. Educational content included behavioral escalation stages, triggers, de-escalation techniques, trauma-informed care, documentation, and …

Weekly Team Validation Rounding Focused On Chlorhexidine Gluconate Bathing And Bath Completion And Documentation Compliance, La-Toya Therese Fong

Walden Dissertations and Doctoral Studies

This quality improvement project evaluated whether weekly team validation rounding improved chlorhexidine gluconate (CHG) bath completion and documentation compliance among eligible adult inpatients, with particular attention to differences in compliance outcomes between Pod 5C and Pod 4B. Background. Hospital-acquired infections continue to increase morbidity, mortality, length of stay, and healthcare costs. Although CHG bathing is an evidence-based strategy for reducing infection risk and the transmission of multidrug-resistant organisms, inconsistent documentation at the practicum site limited accurate monitoring of compliance across validation data, electronic medical record documentation, and DOMO reports. Method. Participants included eligible adult inpatients admitted within the previous 24 …

Confidence Versus Competence: Addressing Nursing Knowledge Gaps In Catheter Care To Reduce Catheter-Associated Urinary Tract Infections, Leslie Anne Villanueva Bautista

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most prevalent and preventable healthcare-associated infections (HAIs), contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare expenditures. Most hospital-acquired UTIs are related to urinary catheters, and this burden costs the United States alone an estimated $340 to $450 million annually (Yang et al., 2022). CAUTIs are UTIs that occur in patients with indwelling urinary catheters. This quality improvement project aimed to increase adherence to existing bladder scanning protocols and strengthen urinary catheter care to prevent CAUTI. Baseline staff nurse knowledge was obtained, and reinterpretation of the facility’s existing protocols and bundles …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Improving Adherence To Remote Patient Monitoring (Rpm) For Patients With Hypertension, Chioma Udegbune

Student Scholarly Projects

Practice Problem: Hypertension is a leading contributor to cardiovascular disease, and suboptimal adherence to remote patient monitoring (RPM) limits opportunities for timely intervention and effective blood pressure management in outpatient primary care.

PICOT: The PICOT question that guided this project was: Among outpatient clinic nursing staff responsible for remote patient monitoring (RPM) in adults with hypertension (P), how does implementation of a structured nurse-led education and reminder protocol (I), compared to standard RPM practices consisting of routine onboarding and passive reminder processes (C), influence patient adherence to RPM protocols (O) over a 10-week period (T)?

Evidence: Evidence supports nurse-led education, …

Staff Education To Integrate The Cdc Prediabetes Risk Test Into Primary Care Intake, Helen Ndangam

Walden Dissertations and Doctoral Studies

This staff education project involves addressing the gap in using a standardized prediabetes screening protocol at an outpatient primary care clinic in Maryland, which leads to missed early interventions. Standardizing this process is vital for nursing practice to promote preventive care and optimize workflows. The practice-focused question was for medical support assistants (MSAs) at an outpatient primary care clinic: How does implementing a competency-based education program on the Centers for Disease Control and Prevention (CDC) Prediabetes Risk Test (Centers for Disease Control and Prevention [CDC], n.d.) affect staff knowledge, workflow confidence, and screening compliance over a 7-week period? The purpose …

Staff Education To Reduce Burnout Among Psychiatric Nurses Caring For Patients With Schizophrenia, Gloria Laizer

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed occupational burnout among psychiatric registered nurses caring for patients with schizophrenia. Workplace violence, compassion fatigue, emotional exhaustion, and staffing shortages place psychiatric nurses at high risk for burnout, threatening nurse well-being, workforce retention, and patient safety. The practice site lacked a standardized resilience education program. The practice-focused question was, In psychiatric nurses caring for patients with schizophrenia, does implementation of an evidence-based resilience education program, compared with current practice, reduce occupational burnout? The purpose was to implement and evaluate such a program, informed by the Johns Hopkins evidence-based practice (JHEBP) Model …

Improving Nurses’ Knowledge Of Barcode Medication Administration Using Structured Education In Group Homes, Bernadette Beleho Woueko

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) educational project evaluated the effectiveness of a structured Barcode Medication Administration (BCMA) education program in enhancing nurses’ knowledge of BCMA and promoting medication safety. Because local BCMA compliance rates were 15 percentage points below the organizational benchmark, an educational intervention was implemented using the Johns Hopkins Evidence-Based Practice Model and the Plan-Do-Study-Act framework. Fifteen staff members, including Registered Nurses, Leaders, and Managers, participated in two educational sessions focused on BCMA use, medication safety, case studies, and role-play activities. Findings demonstrated a significant increase in BCMA knowledge, with scores improving from 68.4% to 86.7% (p < .001). These results support the continuation of BCMA education, competency validation, and training programs to reduce medication errors and enhance patient safety. Keywords: Barcode Medication Administration, BCMA, medication administration errors, nursing education, patient safety, evidence-based practice, educational project.

Implementation Of A Standardized Antibiotic Order Set To Improve Evidence-Based Antibiotic Prescribing In Oral Surgery, Lashundra Miles

Walden Dissertations and Doctoral Studies

Inconsistent antibiotic prescribing practices in an oral surgery clinic contributed to variation in antibiotic selection, timing, dosing, redosing when indicated, and duration. This variation limited adherence to evidence-based prescribing recommendations and highlighted the need for a workflow-based strategy to support antibiotic stewardship. The purpose of this quality improvement project was to increase use of a standardized antibiotic order set through reminder-based reinforcement and to improve evidence-based prescribing practices. The practice-focused question examined whether implementing the standardized antibiotic order set, supported by workflow-integrated reminders and ongoing performance feedback, would improve order-set utilization during a 6-week implementation period. The project was guided …

Improving Rsv Vaccination Uptake Through Nurse-Led Educational Intervention, Lawrence Onuorah

Walden Dissertations and Doctoral Studies

In this quality improvement project, the DNP scholar explored the impact of a nurse-led staff education approach on improving respiratory syncytial virus (RSV) vaccine uptake. RSV disease results in negative health outcomes and even death among vulnerable individuals. Despite the availability of U.S. Food and Drug Administration (FDA)-approved vaccines, uptake remains low due to limited provider knowledge and inconsistent vaccine recommendations. Therefore, the project question addressed whether a staff education program would increase providers’ perceived knowledge of RSV vaccine recommendation and confidence to engage in patient education. The purpose of this quality improvement project was to implement a nurse-led staff …

Stewardship In Action: Reducing Unnecessary Antimicrobial Use In Long-Term Care, Mariatu Sulaiman

Walden Dissertations and Doctoral Studies

Antimicrobial overuse in long-term care facilities (LTCFs) contributes to antimicrobial resistance, avoidable healthcare costs, and adverse drug events, particularly when antibiotics are prescribed for asymptomatic bacteriuria rather than symptomatic urinary tract infections (UTIs). Evidence-based clinical practice guidelines, including the McGeer Criteria, provide standardized approaches for differentiating true UTIs from asymptomatic bacteriuria and supporting appropriate antimicrobial prescribing. The purpose of this evidence-based practice project was to evaluate the development and implementation of a clinical practice guideline incorporating the McGeer Criteria into an antibiotic stewardship program in an LTCF. The practice-focused question examined what evidence supports strategies for reducing unnecessary antimicrobial use …

Standardizing Gestational Diabetes Mellitus Education To Improve Patient Knowledge And Care Consistency In A Prenatal Clinic Setting, Wynn Zara

Master's Projects and Capstones

The gestational diabetes mellitus (GDM) group visit framework aims to improve consistency of GDM education by standardizing referral processes, educational materials, staff workflows, and patient communication. Although evidence-based GDM education supports patient self-management and improved maternal-fetal outcomes, variability in education delivery contributed to inconsistent care within the outpatient maternal-fetal medicine setting. This quality improvement project was conducted in an outpatient maternal-fetal medicine clinic in Santa Clara County serving pregnant patients diagnosed with GDM. To address this gap, a standardized GDM group visit framework was developed and implemented using structured educational resources, referral criteria, and communication workflows. The intervention was evaluated …

Staff Education To Improve Obesity Risk Assessment And Referral Practices, Omolara Aminat Oshokoya

Walden Dissertations and Doctoral Studies

Summary This staff education project addressed inconsistent obesity risk assessment practices in an adult primary care setting. Obesity is associated with increased rates of cardiovascular disease, diabetes, hypertension, and other chronic conditions. At the project site, obesity assessment practices relied largely on body mass index (BMI), resulting in inconsistent identification of obesity-related risks and referral needs. The purpose of this project was to educate providers on the Edmonton Obesity Staging System (EOSS) to improve obesity risk identification and referral practices. The project evaluated whether the staff education intervention improved providers' knowledge and use of the Edmonton Obesity Staging System (EOSS) …

Staff Education To Improve Hypertension Management Knowledge, Angelor Eliscard

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project, I addressed inconsistent staff knowledge of evidence-based strategies for preventing and controlling hypertension among African American women in an outpatient primary care setting. The practice-focused question was: In an outpatient clinical setting, what was the impact of an evidence-based staff education program on healthcare providers' knowledge of hypertension prevention and control strategies for African American women, as measured by pretest and posttest scores? The purpose of this project was to implement and evaluate a structured staff education program to improve providers' knowledge of evidence-based strategies for preventing and controlling hypertension …

Development Of A Clinical Practice Guideline For Hpv Vaccination In Low-Income Adolescents Using The Agree Ii Framework, Jariatu Fatu Bundu

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) vaccination is an effective strategy for preventing HPV-related cancers; however, vaccination initiation and series completion remain suboptimal among adolescents, particularly those from low-income and underserved populations. This Doctor of Nursing Practice project addressed an evidence-to-practice gap involving the absence of a standardized clinical practice guideline (CPG) for HPV vaccination in a family practice setting serving predominantly low-income adolescents. The purpose of the project was to develop and validate an evidence-based CPG to standardize provider recommendations and support improvement in HPV vaccination initiation and series completion. Evidence was appraised and synthesized using the Johns Hopkins Evidence-Based Practice Model, …

Best-Practice Patient Education On Glp-1, Low-Glycemic Diet, Intermittent Fasting, And Exercise For Weight Loss In Obese Nondiabetics, Clara Green

Walden Dissertations and Doctoral Studies

Executive Summary: Clinical Practice Guideline Best-Practice Patient Education on GLP-1, Low-Glycemic Diet, Intermittent Fasting, and Exercise for Weight Loss in Obese Nondiabetics by Clara Green MS, Walden University, 2020 BS, University of Texas at El Paso, 2014 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2026

Implementing A Standardized Counting Process, Paula M. Mbye

Master's Projects and Capstones

Abstract

Background: In a Northern California medical center with 11 operating rooms, two retained foreign object (RFO) events occurred following surgical procedures in 2025.

Problem: Surgical teams rely on manual counting processes to prevent retained foreign objects. Variability in counting practices among registered nurses and surgical technologists, combined with workflow interruptions and environmental distractions, can increase the risk of counting discrepancies and missed items. Standardizing the counting process may improve count accuracy and reduce the risk of RFOs.

Interventions: This quality improvement project implemented a standardized surgical counting process based on Association of periOperative Registered Nurses (AORN) guidelines within …

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Improving Pain Reassessment Within One Hour Of Pain Medication Administration, Geraldine B. Macalma

Master's Projects and Capstones

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, …

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Implementation Of A Structured Safety Planning Intervention In An Outpatient Psychiatric Setting, Ellen Riccio

Walden Dissertations and Doctoral Studies

This organization change process evaluation addressed continued reliance on outdated no-suicide and no-harm contracts in an outpatient psychiatric setting, despite evidence that such contracts do not reduce suicide risk and may create a false sense of security. Adult outpatients with mood or psychotic disorders who express safety concerns represent a population for whom structured, collaborative safety planning is the accepted standard of care. Addressing this gap is central to patient safety and quality nursing care. The practice-focused question asked whether replacing no-suicide contracts with a structured, six-step Safety Planning Intervention would influence safety events, self-harm behaviors, and psychiatric hospitalizations among …

Staff Education To Enhance Phq-9 Depression Screening Compliance, Chibugo Chukwu

Walden Dissertations and Doctoral Studies

This staff education quality improvement project at Clinic P targeted the clinical problem of depression under-diagnosis, evidenced by less than 60% of patients completing the patient health questionnaire (PHQ-9) before the initiative. Depression under-diagnosis, significantly caused by provider PHQ-9 screening competency deficits that need to be addressed through staff education, is associated with adverse patient health outcomes, in turn generating negative implications for providers and wider society. The problem compromises the quality of nursing care because it limits nurses' ability to intervene and deliver timely and effective care to patients with depression. Thus, at Clinic P, this initiative asked how …

Staff Education To Address Verbal De-Escalation Skills In Correctional Mental Healthcare, Mary L. Goodman

Walden Dissertations and Doctoral Studies

This staff education project evaluated the effects of a structured verbal de-escalation training program on self-efficacy among staff in a federal correctional mental health unit. Staff at the site often reported uncertainty managing escalating behaviors, leading to frequent use of restrictive interventions like restraints and seclusion—practices that can compromise safety, quality of care, and raise ethical concerns. To address this gap, an evidence-based curriculum was implemented for 41 multidisciplinary staff, including nurses, certified nursing assistants, and correctional officers. The curriculum included a PowerPoint presentation, role play, and group discussion. A pre–post design measured changes in staff confidence using a modified …

Staff Education Project To Increase Nursing Staff Knowledge Of Falls Prevention In Long-Term Care Facility, Oludele Olagoke

Walden Dissertations and Doctoral Studies

Falls among residents in long-term care facilities are a concern for families and facility management. Falls inflict pain, discomfort, and head trauma, causing fractures. In nursing practice, falls are nursing-sensitive indicators that reflect the quality of nursing care and patient safety. There is a need to bridge the gap and increase staff knowledge on how to prevent falls in the facility. The Doctor of Nursing Practice (DNP) project focused on increased nursing staff knowledge through an evidence-based education program and the implementation of an evidence-based practice education program. The DNP project practice question was about nursing staff in long-term care …

Staff Education To Providers Prescribing Glp-1 Medications For The Treatment Of Obesity, Madeleine Williams

Walden Dissertations and Doctoral Studies

The utilization of glucagon-like peptide 1 (GLP-1) medications has skyrocketed over the past 5–8 years, with an average weight loss of 15–21% of initial weight. Unfortunately, not all providers offer evidence-based patient education when starting a GLP-1 medication for the treatment of obesity. A practice gap I have identified is the lack of consistent evidence-based education providers utilize when prescribing GLP-1 for obesity treatment in the primary care setting. The project site was a hospital-based primary care clinic located in a suburban community in Washington. This staff education aimed to evaluate whether a standardized, evidence-based educational tool on GLP-1 medications …