Digital Commons Network^™

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 …

Staff Education To Reduce Foley Catheter Utilization In Patients With Acute Urinary Retention, Dennis Ulep

Walden Dissertations and Doctoral Studies

Acute urinary retention (AUR) is a common inpatient condition associated with complications such as urinary tract infections, prolonged hospitalization, and impaired mobility when not managed appropriately. Despite evidence supporting intermittent catheterization as a preferred first-line intervention for many patients with AUR, indwelling Foley catheters continue to be overused in acute care settings. Purpose: This Doctor of Nursing Practice (DNP) project evaluated whether staff education on a standardized AUR algorithm would improve evidence-based urinary retention management and reduce unnecessary Foley catheter utilization among nurses caring for adult hospitalized patients on a hematology and oncology unit in a Southern California acute care …

10-Bed Medical-Surgical Telemetry Unit Expansion To Address Inadequate Inpatient Capacity, Sumitpal Kaur

Walden Dissertations and Doctoral Studies

Inadequate medical-surgical telemetry capacity contributes to emergency department (ED) boarding, patient transfers, decreased patient satisfaction, and operational inefficiencies. This systems-level organizational leadership project evaluated a proposed 10-bed medical-surgical telemetry unit expansion at a medical center in Northern California. The project addressed the question of how a 10-bed expansion would affect ED boarding, patient crossovers to a nearby medical center, patient satisfaction, and financial performance. Trend analysis of occupancy, ED boarding, and crossover data, regional benchmarking, and financial modeling using net present value (NPV) and internal rate of return (IRR) were used to evaluate the proposed expansion. The organization currently operates …

Standardizing Interfacility Transfer In And Out Processes Across The Local Va Setting, Petrice Robinson Brown

Walden Dissertations and Doctoral Studies

The quality improvement project focused on the inconsistent documentation and communication of the transfer of veterans in and out of a Veterans Affairs Medical Center. Lack of transparency in handoff knowledge and ineffective documents posed a risk of delayed care and patient injuries. The staff provided an audit tool with staff education to monitor completion of mandatory transfer steps, such as special mode travel approval, equipment needs, nurse-to-nurse handoff, transfer notes, consent, and physician correspondence. This method was based on the evidence found in literature indicating that structured checklists and handoff tools minimize missed information and facilitate safer care transitions …

Staff Education To Reduce Stress In Assisted Living Nursing Staff, Cherechi Onyenso

Walden Dissertations and Doctoral Studies

In this staff education doctor of nursing practice (DNP) project, I addressed a practice gap associated with inadequate staff knowledge of workplace stress-management strategies in an assisted living facility. Workplace stress in nursing practice is a contributing factor to burnout, reduced job satisfaction, poor teamwork, and a decline in the quality of resident care. The practice-focused question for this project was about whether staff knowledge would be enhanced over an 8-week period in comparison to baseline knowledge as a result of their participation in a structured staff education program on workplace stress management. The purpose of the project was to …

Staff Education To Improve Staff Knowledge, Confidence, And Intent To Consistently Implement Medication-Assisted Treatment, Matilda Boachie

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed inconsistent medication-assisted treatment (MAT) implementation in a masked crisis stabilization unit. MAT was available, but staff education was informal and inconsistent, contributing to variation in knowledge, confidence, patient education, documentation, and discharge planning. The practice-focused question that was answered through this project was whether structured staff education would improve knowledge, confidence, and intent to consistently implement MAT. The purpose was to develop, implement, and evaluate structured education for interdisciplinary staff. De-identified pre- and post-education surveys were analyzed with descriptive statistics, and aggregate averages were compared because individual surveys were not matched. …

Staff Education To Standardize Chronic Pain Patient Education In Primary Care, Jessica Okpara

Walden Dissertations and Doctoral Studies

Inconsistent delivery and documentation of chronic pain patient education may contribute to variations in patient knowledge, treatment expectations, and engagement in self-management. This Doctor of Nursing Practice staff education and quality improvement project was designed to standardize chronic pain patient education in a primary care setting. The practice-focused question examined whether implementing standardized chronic pain education, compared with non-standardized education, would improve patient knowledge and use of self-management strategies over 10 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model, the project included development of evidence-based education materials, staff preparation, workflow integration, and a standardized documentation process. Clinic staff identified …

Improving Glycemic Control And Self-Care Among Adult Patients With Type 2 Diabetes Mellitus At A Community Health Center, Lydia Asabea Lartey

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a significant practice concern in community health settings, where adults often encounter barriers to effective self-management, including low health literacy, socioeconomic challenges, and limited access to Diabetes Self-Management Education and Support (DSMES). At the project site, inconsistent staff preparation, high patient volume, and limited standardized teaching resources contributed to gaps between evidence-based standards and routine diabetes education. To address these gaps, the project implemented a standardized, culturally responsive diabetes-education workflow to strengthen care quality, patient safety, and responsible resource use. The practice question guiding the project was: How does implementing a standardized, culturally responsive …

Reducing Nurse Burnout, Oluwarotimi Tunde Aborisade

Walden Dissertations and Doctoral Studies

Nurse burnout is a severe job-related condition that significantly impacts nurses' well-being. Nurse burnout is a growing concern amid the increased demand for healthcare professionals. Research has been conducted to explore nurse burnout and how it affects the quality and safety of patients. Different research has also been conducted to review different interventions to address nurse burnout, including individual and organizational interventions. Some interventions include self-care, mindfulness and meditation, coping and resilience, as well as lifestyle adjustments. Some organizational interventions include workload management, psychological safety, and job redesign. This study was conducted to evaluate the effectiveness of individual interventions to …

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …

Sustaining Clabsi Prevention Through Central Line Bundle Compliance: A Focus On Iv Tubing Labeling, Visual Cues And Peer Support, See Elizabeth Vang

Master's Projects and Capstones

Abstract  

Problem: Inconsistent IV tubing labeling compliance on a telemetry unit was identified as a gap in central line maintenance practices that could affect adherence to the CLABSI prevention bundle.

Intervention: A quality improvement project reinforced existing IV tubing labeling practices through a visual job aid, staff education, and peer verification during Nursing Knowledge Exchange (NKE) bedside handoff.

Outcome Measure: The primary outcome measure was IV tubing labeling compliance, with a goal of increasing compliance from 86.5% to at least 95% on 24 bed Telemetry unit.

Results: The project did not achieve the desired improvement in compliance. Multiple concurrent quality …

Staff Education To Improve C-Ssrs Suicide Risk Screening Competency, Pearl Binka

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed inconsistent administration and documentation of the Columbia-Suicide Severity Rating Scale (C-SSRS) in an acute care mental health setting. The practice problem was important because inconsistent standardized screening could delay identification of patients who required timely safety interventions. The practice-focused question examined whether structured C-SSRS education improved nursing staff competency, screening consistency, and documentation compliance. The project was developed and implemented to strengthen nurses’ knowledge, confidence, and skill in applying the C-SSRS as part of routine suicide risk screening. Evaluation strategies included comparisons of pre- and posteducation knowledge scores, competency checklist completion, chart audit findings, …

Implementation Of An Evidence-Based, Standardized Hypertension Follow-Up Protocol To Improve Quality And Outcomes Among African American Females In A Primary Care Setting, Fausat Oluremi Ojo

Walden Dissertations and Doctoral Studies

Hypertension is a major modifiable risk factor for cardiovascular disease, stroke, kidney disease, and premature mortality. African American women experience a disproportionate burden of hypertension and hypertension-related complications, making timely follow-up and treatment intensification essential quality and equity priorities. This evidence-based practice project implemented a standardized hypertension follow-up protocol in a primary care setting to improve blood pressure (BP) control and follow-up reliability among African American females ages 18 to 65 with a hypertension diagnosis. The project population included 67 patients, numbered 1 to 67. Baseline BP report data showed that 47 patients had BP less than 140/90 mm Hg, …

A Program Proposal For An Evidence-Based Dietary Program To Support Spanish Speaking Diabetic Patients, Shaquetta Ann Mccloud-Petion

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) executive leadership system improvement project addresses provider-identified gaps in dietary education for Spanish-speaking patients with diabetes, which may contribute to suboptimal glycemic control and diabetes self-management. A comprehensive review of evidence from CINAHL Complete, PubMed/MEDLINE, and Cochrane supports the use of culturally tailored, evidence-based dietary education to improve diabetes knowledge, self-management behaviors, and health outcomes. The project proposes the development and implementation of a standardized dietary education program using culturally appropriate dietary exchange tools within an outpatient clinic. The initiative aims to improve staff confidence, adoption, and consistency in delivering culturally responsive diabetes education …

Staff Education On Psychoeducation Delivery To Enhance Medication-Adherence Education For Adults With Bipolar Disorder In An Outpatient Psychiatric Mental Health Facility, Bibiana Chinwe Ndula

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed inconsistent delivery of evidence-based medication-adherence psychoeducation for adults with bipolar disorder (BD) in an outpatient psychiatric mental health facility. The project question was whether an 8-week structured module, in relation to existing staff education practices, would increase staff knowledge and confidence. The intervention was guided by the Johns Hopkins evidence-based practice (JHEBP) model and comprised a PowerPoint presentation, a facilitator guide, a handout, a checklist, a toolkit, and anonymous pre- and post-training assessments. Eight out of ten invited staff completed the project. The mean knowledge rose from 6.1 to 8.9 …

Implementation Of A Nightshift Sleep Promotion Bundle To Support Delirium Prevention In A Neurosurgical Intensive Care Unit, Pamella Simpson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project aimed to identify the need for a consistent sleep-promotion protocol in an adult neurosurgical intensive care unit (NSICU). Disrupted sleep is a frequent problem for patients who are seriously ill and can lead to delirium, longer hospital stays, higher health care expenses, diminished cognitive function, and death. While there was evidence supporting nonpharmacological sleep-promotion and delirium-risk-reduction interventions, they were not consistently implemented at the project site, creating a gap between evidence and clinical practice. The purpose of this project was to implement and evaluate an evidence-based night-shift sleep-promotion bundle. The practice-focused …

Staff Education To Improve Knowledge On Accurate Administration Of Medication, Deepu Pudasaini

Walden Dissertations and Doctoral Studies

Medication errors have been a significant problem, primarily due to a lack of continuous monitoring and inadequate training for personnel involved in managing or administering medications in non-healthcare settings. These errors often go undetected or unreported. This Doctor of Nursing Practice (DNP) project was a staff education project to improve staff knowledge of accurate medication administration of medication in a group home. The practice-focused question was: Will a staff education program on the accurate administration of medication improve certified medication technicians’ (CMTs) knowledge about the association between the medication administration process and medication error? The purpose of this DNP staff …

Improving Identification And Initial Management Of Perimenopause In Primary Care, Yewande Banire

Walden Dissertations and Doctoral Studies

Perimenopause is a common but frequently underrecognized stage of reproductive aging that can significantly affect women's physical, psychological, cognitive, and sexual well-being. In primary care, inconsistent provider education and the absence of standardized screening and assessment processes often contribute to delayed recognition and fragmented management. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based clinical practice guideline to improve the identification and initial management of perimenopause in a primary care setting. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved synthesizing and critically appraising the literature to develop …

Educating Psychiatric Mental Health Nurse Practitioners On Long-Acting Injectable Antipsychotic Medication Management, Omonzua Mabel Eromosele

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed the underutilization of long-acting injectable (LAI) antipsychotic medications in an outpatient mental health center. Although LAI antipsychotics improve medication adherence, reduce relapse, and decrease psychiatric hospitalization, provider knowledge deficits and inconsistent prescribing practices lead to their underuse. The practice-focused question was: Among psychiatric-mental health nurse practitioners (PMHNPs) in an outpatient mental health center, what is the impact of an educational program on the application of LAI antipsychotic medication management on the improvement of staff knowledge? The purpose of this project was to implement and evaluate evidence-based educational intervention to improve …

Enhancing Cultural Competency Through Training In A Primary Care Clinic, Rogelio Perez Iii

Doctor of Nursing Practice Projects

Cultural competence remains essential in primary care settings serving diverse populations, yet staff at a small Southern Texas primary care clinic reported no previous formal cultural competency training in workplace orientation or school. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a brief, evidence-based cultural competency intervention improved clinician cultural competency scores. Madeleine Leininger’s Culture Care Theory provided the theoretical framework, Lewin’s Change Theory guided the change process, and the Plan-Do-Study-Act cycle directed implementation and evaluation. The problem addressed was the lack of structured training to support culturally responsive communication, patient trust, and …

Reduction Of Length Of Stay For Total Joint Replacement Patients, Melody C. Golden

Master's Projects and Capstones

Abstract

Problem: Prolonged LOS in the PACU for patients undergoing total joint replacement surgery contributes to inefficiencies in patient flow, delayed throughput, and increased resource utilization. At Hospital A, recent LOS averages exceed internal and regional benchmarks, indicating a need for process improvement.

Context: The PACU is a high-volume, fast-paced environment requiring coordination among nursing, physical therapy, anesthesia, and discharge planning teams. Variability in workflow, communication gaps, and inconsistent timing of key processes contribute to delays in discharge readiness.

Interventions: From May through July 31^st, 2026, a quality improvement project was implemented using the Baldrige Excellence …

Evaluation Of Implementation Of An Evidence-Based Screening Tool For Genitourinary Syndrome Of Menopause, Anna L. Myers

Doctor of Nursing Practice Projects

Genitourinary syndrome of menopause (GSM) is a prevalent yet underrecognized and undertreated condition despite evidence-based therapies in the urology setting. The purpose of this Doctor of Nursing Practice quality improvement was to provide education on the 2025 American Urological Association/ Society of Urodynamics and Female Pelvic Medicine & Urogenital Reconstruction/American Urogynecological Society GSM guidelines and integrate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire into practice, evaluate outcomes of acceptability, appropriateness, and feasibility of the intervention, and the impact on diagnosis and associated GSM prescribing. The aim was to impact provider screening and treatment of patients with GSM. Kolcaba's Comfort …

High-Flow Nasal Cannula Oxygen Therapy Versus Standard Oxygen Therapy On Perioperative Outcomes In Patients Undergoing Transcatheter Aortic Valve Replacement, Kirsten B. Whiteside, Jacqueline M. Case

Graduate Theses, Dissertations, and Capstones

Abstract 

Background and Purpose: Transcatheter aortic valve replacement (TAVR) is increasingly performed under monitored anesthesia care (MAC) to facilitate faster recovery and reduce complications associated with general anesthesia. Standard oxygen therapy (SOT) may be insufficient in maintaining adequate oxygenation in this high-risk population. High-flow nasal cannula (HFNC) therapy has emerged as a potential alternative. This literature review evaluates the effects of HFNC compared with SOT on perioperative outcomes in patients undergoing TAVR under MAC. 

Methods: A comprehensive review of the literature was conducted to identify studies evaluating HFNC versus SOT during TAVR procedures performed under MAC. Six studies met inclusion …

Improving Diabetic Retinopathy Screening Among Adults With Diabetes In Boston, Massachusetts: A Policy Brief For Primary Care Implementation, Amber L. Auger

Capstones

No abstract provided.

Implementation Of A Cognitive Aide To Guide The Use Of Non-Invasive Hemodynamic Monitoring For Goal-Directed Fluid Therapy During Cesarean Deliveries, Ashley George, Ashley Walbert

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, with delayed recognition contributing to adverse outcomes during cesarean delivery. In cesarean deliveries, traditional intermittent non-invasive blood pressure monitoring may not detect early hemodynamic instability, creating a need for more structured interpretation of continuous hemodynamic data. This Doctor of Nurse Anesthesia Practice quality improvement project implemented a cognitive aid to support anesthesia providers using the Edwards EV1000/ClearSight platform during goal-directed fluid therapy. A pre–post implementation design using provider surveys evaluated feasibility, usability, confidence, and perceived impact. By organizing continuous values such as stroke volume, cardiac output, and systemic …

A Staff Nurse-Led Clinical Instructional Competency Program To Improve Clinical Judgement In Undergraduate Nursing Students: A Quality Improvement Initiative, Shana Skeffrey

Doctor of Nursing Practice (DNP) Manuscripts

There is increasing concern that new graduate nurses are leaving bedside roles early in favor of less stressful positions due to rising patient acuity and heightened organizational expectations, increasing the effects of the nursing shortage (McClosky et al., 2022; AACN, 2024). A standardized clinical experience, combined with fair and consistent access to skill application in the hospital setting can support a collaborative approach for undergraduate nursing students. This quality improvement project is aimed to implement a Staff Nurse-Led Clinical Instructional Competency Program that will provide a structured opportunity for clinical instructors to help fill the gap in preparing undergraduate nurses …

A Quality Improvement Initiative Utilizing Help To Reduce Delirium, Improve Patient Outcomes, And Provide Age Friendly Care For Patients 65 Years Of Age Or Older With Modifiable Delirium Risk Factors., Maggie Blake

Doctor of Nursing Practice (DNP) Manuscripts

Background: Delirium, an acute change in cognition, occurs in 21% of hospitalized patients and is linked to increased length of stay, readmissions, and increased mortality (Shen et al., 2024). In older adults, delirium prevalence increases and is linked to poor outcomes that inhibit patients' health care goals (Shen et al., 2024). Despite the well-published harms of delirium and standardized prevention measures, delirium prevention is not prioritized. Methods: HELP, originally the Hospital Elder Life Program, now preferred to be known as HELP, is a standardized delirium prevention model specifically designed to address the unique needs of hospitalized older adult patients. HELP …

Improving Chlamydia Testing For Females Through Universal Screening In Outpatient Pediatric Primary Care: An Adolescent Quality Improvement Initiative, Christina Howard

Doctor of Nursing Practice (DNP) Manuscripts

Chlamydia is the most common sexually transmitted infection in the United States in adolescents and young adults (Dutra & Lazenby, 2023). Per Smith, Reirden, and Nyquist (2022), adolescents and young adults between the ages of 15 and 24 account for more than 60% of new chlamydia infections each year. Testing for chlamydia is not standardized, and it is estimated that only 50% of those who qualify receive a yearly screening American Sexual Health Association. (2021). If outpatient testing and treatment is not improved these asymptomatic cases will be missed, infections in general will increase, and reinfections may occur leading to …

Enhancing New Graduate Nurse Confidence And Patient Safety Through Clinical Development Coach Integration, Megan T. Kramer

Doctor of Nursing Practice (DNP) Manuscripts

The transition from student to professional nurse is a critical developmental stage often marked by heightened stress, emotional exhaustion, and uncertainty in clinical judgment. These challenges frequently contribute to lower confidence levels, increased anxiety, and higher risks for patient safety events among new graduate nurses. This program evaluation project aims to assess the effectiveness of integrating a Clinical Development Coach (CDC) role to enhance new graduate nurse’s confidence, comfort, and overall competence while reducing patient safety incidents on a trauma/surgical inpatient unit in a medical center on the East coast. The CDC role is a structured mentorship and resource position, …

Implementation Of A Deteriorating Patient Simulation For New Graduate Nurses To Improve Clinical Judgment: A Quality Improvement Project, Kasey Mundell

Doctor of Nursing Practice (DNP) Manuscripts

New graduate nurses (NGNs) often have trouble recognizing and responding to patient deterioration because of limited clinical judgment and confidence during the transition to practice. This quality improvement project evaluated the implementation of a high-fidelity deteriorating patient simulation within a new graduate nurse orientation program at a Level I trauma center. Guided by the Plan-Do-Study-Act framework and the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice, the simulation focused on the assessment and management of a patient experiencing pulmonary embolism. Eight NGNs participated in the simulation and completed the Attitudes Toward Recognizing Early and Noticeable …