Digital Commons Network^™

Educating Staff On Using Medication-Assisted Treatment (Mat) In Opioid Use Disorder (Oud), Demie Alaekwe

Walden Dissertations and Doctoral Studies

Medication-assisted treatment (MAT) programs, especially those led by providers, can expand access to care for persons with opioid use disorder (OUD). The gap in practice at the site was the insufficient knowledge among nurses on how to effectively use MAT in treating OUD. The purpose of this staff educational project was to design and implement a training module to educate mental health providers on the principles and interventions of MAT. The practice-focused question was: Does educating nurses on MAT principles while incorporating evidence from the literature improve their knowledge as measured by pre- and post-test? The ADDIE pedagogy model was …

Exploring The Relationship Between Burnout, Professional Fulfillment, And Individual And Organizational Factors In Nurse Managers Across Ambulatory And Inpatient Settings, Yulia Romazanova Lopez

MUSC Theses and Dissertations

Nurse managers play a vital role in the functioning and stability of healthcare systems, yet their well-being remains an underexplored area of research. The COVID-19 pandemic brought renewed attention to occupational burnout, including in nursing leadership, where nurse managers reported high levels of stress, emotional exhaustion, and organizational strain. While the literature on burnout has grown rapidly in recent years, there is limited research that addresses what comes next, what sustains nurse managers in their roles and how organizations might foster their long-term well-being and engagement. This dissertation compendium explores professional fulfillment (PF) as a proactive and constructive lens for …

Implementing An Antibiotic Stewardship Program For Acute Respiratory Tract Infections In Urgent Care, John Childree

Doctor of Nursing Practice Projects

Antibiotic overprescription for acute respiratory tract infections (ARTIs) remains a persistent challenge in urgent care, contributing to antimicrobial resistance and increased healthcare costs. This quality improvement project evaluated whether a structured educational intervention an Antibiotic Stewardship Program (ASP) could improve providers’ knowledge and self-efficacy in evidence-based prescribing. A quasi-experimental, single-group pre-post design was used with seven urgent care clinicians. Data were collected through a custom Antibiotic Stewardship Questionnaire and a Self-Efficacy Survey administered before and after the intervention. Results demonstrated a 17% increase in knowledge scores (from 9.3 to 10.6 out of 11) and a statistically significant improvement in self-efficacy …

Respectful Patient-Provider Communication And Patient Portal Usage In Pregnant People Of Color, Amy H. Goh, Christopher Lee, Chisolum Nkenke, Joyce K. Edmonds

College of Health Professions Faculty Papers

BACKGROUND: Patient-provider communication (PPC) increasingly occurs in online patient portals. Variations in portal usage might worsen communication inequities for pregnant people of color (POC), widening the digital divide. The objective of this study was to examine the relationships between respectful PPC, patient portal usage, and digital health literacy (DHL) in pregnant POC.

METHODS: A multimethod cross-sectional survey design was used. Ordered logistic regression was performed to determine the relationship between PPC and portal use, controlling for trimester prenatal care was initiated, insurance type, age, gestational age, and parity. The moderating effect of Digital Health Literacy Instrument (DHLI) was tested on …

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

Doctoral Dissertations and Projects

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

Improving New Graduate Nurse Clinical Judgment By Training Preceptors On The Use Of The Tanner Model, Denise E. Carr

Doctoral Dissertations and Projects

New graduate nurses (NGNs) often enter the workforce with deficits in clinical judgment, which has been further exacerbated by pandemic-related limitations in clinical education. This project aimed to improve NGN clinical judgment by training preceptors to use the Tanner Clinical Judgment Model (TCJM) and Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental evaluation design was used to compare outcomes between two groups of preceptor–preceptee pairs. Half of the preceptor participants received training on the TCJM and LCJR, while the other half did not. Clinical judgment development was measured using the LCJR pre- and post-orientation. Additional preceptor feedback regarding the implementation and …

Do Perceived Social Support And Positive Religious Coping Moderate Any Relationship Between Post-Intensive Care Syndrome–Family Symptoms And Quality Of Life In Informal Caregivers Of Intensive Care Unit Survivors?, Carol R. Hirschkorn

Doctoral Dissertations and Projects

Family members and close friends often act as informal caregivers (CGs) for survivors of critical illness, assisting with activities of daily living, ongoing care needs, and adjustment to life after critical illness. These CGs simultaneously cope with their own mental, physical, and social sequelae, including significant changes (to roles and responsibilities) in everyday life. Qualitative researchers have examined this constellation of CG symptoms, which constitute post-intensive care syndrome–family (PICS-F), to understand the experiences, needs, and coping of CGs of intensive care unit (ICU) survivors. None have looked at the impact of religious coping and perceived social support on PICS-F and …

Lived Experiences Of Nurses Caring For Patients With Opioid Use Disorder, Oneatha Alexander

Walden Dissertations and Doctoral Studies

Opioid abuse is a significant problem in the United States. People with opioid use disorder (OUD) visit the emergency room (ER) for pain management. OUD is the overuse and abuse of opioids, which can result in dependence, relapses, and death. Nurses in the ER and medical-surgical units face challenges in distinguishing OUD from chronic pain. The purpose of this qualitative interpretive phenomenological study, guided by Benner’s novice-to-expert framework, was to explore the lived experiences of ER and medical-surgical nurses who provide care to OUD patients. Eight ER and medical-surgical nurses were interviewed using semi-structured interviews. The main themes from coding …

Humanizing The Icu: Implementation Of Personalized Communication Boards In The Sicu Drives Enhanced Patient And Family Experience, Stephen D. Hoefler

Master's Theses

Objective: Research has established the importance of personalized communication in critical care settings, where standardized tools like whiteboards can improve patient and family engagement.

Aim: This project aims to develop a personalized communication board in the surgical intensive care unit (SICU) at a Bay Area academic quaternary care facility that, once implemented, will achieve at least 75% utilization in patient rooms by May 2025, enhancing communication and patient experiences.

Methods: Surveys were conducted with patients, families, and staff to gather stakeholder input and guide the design of a new standardized whiteboard model with personalized elements. Results: Based on stakeholder feedback, …

Psychometric Evaluation Of The Thai Version Of Emotional Labor Scale (T-Els) In Thai Nurses, Vachira Posai, Wisarut Srisintorn, Paramee Thongsuksai, Chanokporn Jitpanya

Journal of Health Research

Background: Nurses often face emotional strain due to emotional labor (EL), which involves concealing or modifying genuine feelings to meet their job requirements. This response can lead to physical, psychological, and behavioral issues. The Emotional Labor Scale (ELS), originally in English, has not been translated into Thai, leaving its psychometric properties unexamined in the Thai context. This study aimed to translate the ELS into Thai and evaluate its psychometric properties among Thai nurses.

Methods: A cross-sectional study design was used. The 14-item scale, which includes surface acting, deep acting, and expression of naturally felt emotions dimensions, was translated using forward …

Using The Token Economy To Improve Show Rates In An Outpatient/Community Mental Health Clinic, Gertrude Nabila Ndansi

Walden Dissertations and Doctoral Studies

The type of project was a quality improvement intervention. The identified practice problem was limited appointment shows among patients with appointments. Outpatient clinics often struggle with patients not showing up for appointments. Addressing this gap was critical for improving patient outcomes and resource efficiency. The practice problem must be addressed within the context of nursing practice by enhancing access to consistent mental health care and giving patients more timely support, leading to better outcomes and overall wellbeing.

A Clinical Practice Guideline For Enhanced Rehabilitation Assessment In Poststroke Patients, Chanda Honeywood

Walden Dissertations and Doctoral Studies

This doctoral project aimed to develop clinical practice guidelines (CPG) to strengthen the assessment of poststroke patients for rehabilitation. The project sought to adopt an evidence-based approach to develop standardized recommendations that can help in the timely and appropriate rehabilitation of stroke survivors, thereby reducing the risk of long-term disability and readmissions. Stroke is a significant cause of disability and poor functional recovery, increased healthcare costs, and lower quality of life for patients occur because of poor rehabilitation assessment. While rehabilitation protocols already exist, discrepancies in patient evaluations result in intervention delays and ineffective uptake of rehabilitation programs, limiting the …

Preoperative Clinical Practice Guidelines For Patients Undergoing Coronary Artery Bypass Graft Surgery, Marjorie Badong Yumul

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Marjorie B. Yumul has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Patricia Schweickert, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Executive Summary: Clinical Practice Guideline Preoperative Clinical Practice Guidelines for Patients Undergoing Coronary Artery Bypass Graft Surgery by Marjorie B. Yumul MS, University of the Philippines Manila, 2003 BS, La Concordia, …

Maternal Access For Depression In Rural Environments, Simone Parlier

Dissertations

Significance –As many as 25% of birthing persons experience postpartum depression (PPD) within the first year after childbirth making this one of the most common postpartum disorders. PPD is prevalent, incapacitating, and treatable. The first step is identifying those at risk. Rural birthing persons are understudied, and may have unique predisposing characteristics as well as geographic challenges for optimal detection and treatment of PPD. Purpose -The long-term goal is to improve the health of rural families. Using The Theory of Unpleasant Symptoms, the purpose of this descriptive, cross-sectional research was to describe the prevalence of PPD in rural birthing persons …

Registered Nurses’ Perceptions Of Patient Safety In Critical Care Units, Martha Benghie Hyacinthe

Walden Dissertations and Doctoral Studies

Patient safety is a cornerstone of effective healthcare delivery, particularly in critical care units (CCUs) where patients are at heightened risk of complications due to their complex medical conditions. The purpose of this study, guided by Watson’s theory of human caring, was to explore RNs’ perceptions of patient safety in CCUs. Data on eight RNs working in CCUs were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Data were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Using Saldana’s method of thematic analysis, three overarching themes emerged: patient safety, resource allocation, and …

Bereavement Needs Of Parent-Child Dyads Following Sibling Death, Shannon V. D'Alton

MUSC Theses and Dissertations

In the United States, nearly 62,000 children and adolescents experience the death of a sibling each year and sibling bereavement is one of the most distressing life events during childhood; however, it has received less attention in research compared to other forms of childhood loss. Bereaved siblings and parents are at increased risk for negative physical and psychological outcomes, yet little is known about their support and resource needs during the early years following the death. A limitation in understanding sibling bereavement is the methodological and ethical challenges of researching this vulnerable population. Consequently, the bereavement needs of surviving siblings …

Policy Paper Assessing The Risk Of Obstructive Sleep Apnea In The College Football Player, Joseph C. Archer

Doctor of Nursing Practice Projects

Sleep is a vital yet often overlooked component of athletic performance, particularly in collision sports such as football. Despite growing evidence connecting obstructive sleep apnea (OSA) with cognitive impairment, cardiovascular risk, and injury, standardized screening is rarely implemented in collegiate athletics. This project aimed to assess the risk of obstructive sleep apnea (OSA) in college football players aged 18–25 using the STOP-BANG screening tool and to evaluate the impact of an educational intervention on the knowledge of athletic trainers. The purpose was to identify at-risk athletes early, promote timely intervention, and improve athletic trainers' understanding of OSA. The project addressed …

Staff Education To Registered Nurses On An Inpatient Pediatric Unit Regarding Pediatric Burn Principles, Qwinnetta Janae Stokes

Walden Dissertations and Doctoral Studies

The purpose of this staff education project was to improve nurses’ knowledge on burn care using an educational intervention. The project site became the children's hospital designated burn unit. Children with burns were a new patient population that the project unit had never cared for, and there was no formal training or competencies for nurses caring for these patients. Nurses requested formal education before being expected to care for these patients. This project utilized a single group, pre-post design comparing knowledge of bedside surgical nurses about pediatric burn care management principles before and after the educational intervention. The intervention was …

Staff Education On Substance Use Screening In An Outpatient Mental Health Clinic, Kelvin Okwudiogor

Walden Dissertations and Doctoral Studies

This DNP project aimed to enhance the quality of care by improving healthcare providers’ knowledge and fostering confidence in the utilization of screening, brief intervention, and referral to treatment (SBIRT). At the practice site, patients were not screened for substance use due to the lack of provider knowledge on evidence-based screening tools. The practice-focused question for this project was, Among healthcare providers in outpatient mental health clinics, does education on the use of the SBIRT screening tool increase their knowledge and skill after educational intervention? The project used a sample of 12 healthcare professionals, including four mental health practitioners and …

Dementia Care: The Role Of Experiential Learning In Nursing Education, Jeannie Simpson

Wisdom & Compassion: The LUSON Journal

The escalating global prevalence of dementia necessitates enhanced educational strategies to prepare nursing students to care effectively for individuals living with dementia. Traditional methods in nursing education predominantly focus on pharmacological treatments and basic caregiving strategies, often neglecting innovative approaches like the Music & Memory® program, Virtual Dementia Tour®, and Montessori dementia. By including these innovative approaches, future nurses will be better equipped to develop and implement person-centered care for individuals living with dementia to improve their quality of life. The integration of these approaches will also meet the growing demands of dementia care, aligning with global health mandates.

Exploring Prelicensure Bsn Students’ Knowledge Of Mindfulness Meditation Using A Smartphone App To Manage Stress And Promote Resilience: A Qualitative Single Case Study, Beth Kelley, Kara Schacke, Alex Boggs, Shelley Blackwood

Wisdom & Compassion: The LUSON Journal

Stress is a detrimental factor in nursing school. Stressors contribute to an unacceptable nursing student attrition rate that has risen to 30% in 2021. The problem is that prelicensure, Bachelor of Science of Nursing (BSN) students' knowledge of mindfulness meditation using a smartphone app to manage stress and promote resilience is not known. Therefore, the purpose of this qualitative case study was to explore pre-licensure, BSN students’ knowledge of mindfulness meditation using a smartphone app to manage stress and promote resilience.

Children In Foster Care: Outcomes And Nursing Implications, Rachel A. Joseph, Emily Etterman

Wisdom & Compassion: The LUSON Journal

Background: Approximately 407,000 children remained in the foster care system by the end of 2020, with 217,000 entering and 224,000 exiting the system. The foster care system is meant to be a temporary living arrangement for children born into or raised in non-flourishing homes. However, the uniqueness of the system and the interactions of foster parents lead to undesirable foster home situations while the child is left in the system for longer times. The child in foster care faces several adverse life events that make it difficult for the child to develop into a successful adult. Purpose: This paper examines …

Volume 2, Issue 2 - Complete Issue

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Stakeholders' Expectations And Experiences Of Being Involved With A Global Accreditation Process For Midwifery Centres In Lmics: A Rapid Ethnography, Summer M. Aronson, Laura Batinelli, Lucia Rocca-Ihenacho, Jennifer R. Stevens

College of Health Professions Faculty Papers

BACKGROUND: This study explored the expectations and experiences of stakeholders involved in the accreditation of midwifery centres (MCs) in low- and middle-income countries (LMICs). With increasing evidence that MCs provide safe, respectful, and evidence-based care that improves maternal and neonatal outcomes, accreditation may serve as a mechanism to bridge quality gaps in maternal health systems, particularly in regions with high maternal and neonatal mortality.

METHODS: A rapid ethnographic approach, combining participant observation and semi-structured interviews, was conducted in partnership with the GoodBirth Network (GBN), which identified six pilot midwifery centres in Haiti, Uganda, and South Africa. Convenience sampling was applied, …

Nurse Led Staff Education Program For Workplace Stress Reduction, Ebony Sudduth

Walden Dissertations and Doctoral Studies

This doctoral project evaluated the impact of a staff education program aimed at increasing healthcare workers' awareness of workplace stress dangers among teammates in an outpatient hemodialysis center. The identified practice issue was limited knowledge about the facilitators, adverse outcomes, and resources related to occupational stress in healthcare. Lack of education regarding the risks of work-related stress presents a critical concern in nursing practice, significantly affecting caregiver well-being and patient outcomes. Nurses, particularly in high-pressure environments such as hemodialysis centers, often experience unrecognized and unmanaged emotional and physical demands, leading to chronic stress and burnout. Hemodialysis nurses are especially susceptible …

Personalized Pain Management Pathway Based On Individual Diagnoses, Tiana Bell Asn, Rn, Diana Desmornes Asn, Rn, Autumn Dwyer Bsn, Rn, Monica Foley Asn, Rn, Marissa Forleo Bsn, Rn, Heather Mcmillan Asn, Rn, Nicole Valenti Bsn, Rn

Posters

The intervention we’re proposing offers a comprehensive, individualized approach to pain management, taking into account diagnosis-specific pain scales, nonpharmacological interventions, and continued pain control post-discharge.

Nursing Advocacy In Maternal Health For Women With Sickle Cell Disease, Jodian Lyn

Loma Linda University Electronic Theses, Dissertations & Projects

Over 80% of pregnancy-related deaths among Black women in the U.S. are preventable. Racial disparities, biases, and discrimination negatively impact maternal health, by contributing to higher stress levels, affecting pregnancy outcomes. The maternal death rate for Black women with sickle cell (SCD) is 629, Black women without SCD is 12, and the general population 6 per 100,000. The voices of these women are often missing in research.

This qualitative study, using Hermeneutic Phenomenological approach, explores the lived experiences of Black women with SCD during pregnancy. Data analysis was completed using an interpretive framework to elucidate the essence of the lived …

Tobacco, Alcohol, And Poverty In Lao Pdr Based On National Survey Analysis, Robert M. Semakula

Loma Linda University Electronic Theses, Dissertations & Projects

Tobacco and alcohol use are among the most prevalent and harmful addictive behaviors globally, including in the Lao People’s Democratic Republic (Lao PDR). In Southeast Asia and the Western Pacific, substance use patterns are shaped by cultural, social, economic, policyrelated, and environmental factors. This study aimed to: (1) explore associations between different patterns of alcohol and tobacco use among men and women in Lao PDR, and (2) investigate the effect of poverty on the relationship between alcohol and tobacco use. We conducted a secondary analysis of the 2013 Lao National Adult Tobacco Survey (N = 9,706), a nationally representative sample …

Predictors Of Nursing Students' Stress, Anxiety, And Depression During The Covid-19 Pandemic In A Hispanic-Serving University In South Texas: A Cross-Sectional Study, Maria I. Diaz, Eleftherios Gkioulekas, Nancy Nadeau

School of Mathematical & Statistical Sciences Faculty Publications

Background: In nursing education, there have been several studies on the impact of the COVID-19 pandemic on the ability of nursing students to cope while in nursing school.

Purpose statement: The goal of this study is to assess undergraduate nursing students' support mechanisms as predictors of stress, anxiety, and depression during the COVID-19 pandemic within a Hispanic-serving institution in South Texas.

Methods: Across-sectional design was used in this study. An online survey using self-reported questionnaires was used to gather data from an undergraduate nursing student cohort during the Fall 2021 semester. Linear regression was used to identify the predictors of …

Weight Recidivism Post-Bariatric Surgery: A Lifestyle Modifications Educational Intervention, Kimeshia N. Johnson

Electronic Theses and Dissertations

Weight recidivism after bariatric surgery is a frustrating phenomenon for bariatric surgery patients and healthcare professionals. A 90-day lifestyle modification intervention for patients at least 18 months postsurgery was performed in the primary care setting to determine if a structured program could promote or maintain weight loss. The intervention aimed to investigate if participation in a structured lifestyle modification program would impact the body mass index of bariatric patients at least 18 months postsurgical intervention. In coordination with a nutritionist specializing in addiction and obesity education, a booklet detailing the guidelines for a 12-week program was provided to 41 bariatric …