Working With Patients Who Self-Injure: An Open Label Study Of An Educational Intervention To Upskill Emergency Nurses On Non-Suicidal Self-Injury, Penelope Hasking, Amanda Aiyana, Jonathon Burcham, Samantha Carey, Joanne M. Dickson, Daniel Fatovich, Logan Hopkins, Eme John, Shirley Mcgough, Chloe Mclean, Irene Ngune, Alex Wheeler

Research outputs 2022 to 2026

Non-suicidal self-injury (NSSI), deliberate damage to body tissue with no intent to die, is not engaged with suicidal intent but is the most reliable predictor of later suicidal behaviour. This makes efforts to reduce self-injury critical. Emergency departments can be the gateways to care for many people who have self-injured and optimal sites for interventions that promote recovery. However, emergency nurses have anecdotally reported that they lack training and feel ill-equipped to provide care for patients who self-injure. In this open label trial (where both participants and researchers were aware who received the intervention), all nurses in a metropolitan emergency …

Staff Education To Improve Knowledge Of Wound Documentation Skills Among Inpatient Nurses, Rouine Kay Patron Litorja

Walden Dissertations and Doctoral Studies

While many healthcare organizations have established wound documentation protocols, maintaining consistent, high-quality documentation remains a widespread challenge in clinical practice. In this staff education project, I addressed the implementation of a staff education program to increase nurses' knowledge about evidence-based practices regarding wound documentation. The staff education initiative was conducted in a medical telemetry unit, with 17 nurses participating. A pretest-posttest design was employed to evaluate the impact of the education. The aggregate pretest and posttest scores were analyzed using the Normalized Learning Gain (NLG) formula. The NLG gain of 0.37, equated to a 37% improvement in knowledge a moderate …

Hazing Prevention Education, Elianna Mielbrecht, Sky Agpawa, Ceirra Dean, Joseph Arinaza, Moses Hart, Lily Speakman, Hana Maow

Nursing Leadership in Community Engagement Projects

Hazing Prevention Education

Hazing in higher education is often hidden behind a culture of secrecy, tradition, or team-building. It includes any unwanted physical, emotional, or psychological activities that a person undergoes before joining a group that has clear lasting impacts on the person’s health, regardless of willingness to participate (H.R.5646 - Stop Campus Hazing Act, 2024; Boyer, A., n.d.). Seven nursing students partnered with a university’s campus security office in Seattle, Washington. This department is responsible for maintaining a safe and respectful campus environment, making it a key stakeholder in hazing prevention efforts.

Guided by the Stop Campus Hazing Act …

Opioid Use Disorder Within The Emergency Department: Not All Skin Infections Are Equal, Jennifer E. Pletcher

Graduate Doctoral Dissertations

The emergency department (ED) is where two health crises commonly converge, the opioid crisis and cellulitic infections while simultaneously being the front door to the healthcare system at large. The aim of this dissertation is to fill the gap in knowledge about specific skin and soft tissue injury and severe infection (SSTI) with comorbidity of opioid use disorder (OUD) (OUD SSTI) population and demonstrate inequities as compared to the SSTI and severe infection without OUD comorbidity (non-OUD SSTI) through the lens of the Conceptual Model of Nursology for Enhancing Equity and Quality: Population Health and Health Policy. The Nationwide Emergency …

The Mediation Effect Of Resilience And The Moderation Effect Of Hospital Magnet Status On The Relationship Between The Practice Environment And Turnover Intentions Among Acute Care Nurses, Elizabeth Fraser

Graduate Doctoral Dissertations

ABSTRACT

THE MEDIATION EFFECT OF RESILIENCE AND THE MODERATION EFFECT OF HOSPITAL MAGNET STATUS ON THE RELATIONSHIP BETWEEN THE PRACTICE ENVIRONMENT AND TURNOVER INTENTIONS AMONG ACUTE CARE NURSES

May 2025

Elizabeth Helena Fraser, B.S.N., Elms College

M.S.N., Emmanuel College

Ph.D., University of Massachusetts Boston

Directed by Professor Sun S. Kim

The U.S. healthcare system has long suffered a critical nursing shortage, intensified since the coronavirus disease 2019 (COVID-19) outbreak. The shortage is a complex national crisis compounded by the high turnover of qualified nurses. Turnover is when a nurse leaves an organization for another nursing position or leaves the profession …

Staff Education Program On Strategies To Manage Disruptive Patient Behavior, Lazare Ngah Shadzeka

Walden Dissertations and Doctoral Studies

The practice concern was the absence of a consistent method of providing structured training on the management of disruptive patient behaviors to staff in a mental health ambulatory care clinic. This clinical gap is important because it heightens the risk of workplace violence, staff burnout, and suboptimal patient care outcomes. The doctoral project practice-focused question was, How does a focused staff education program on dealing with disruptive patient behavior impact nursing staff abilities and confidence in an outpatient clinic setting? Thus, the purpose of this doctoral nursing project was to develop and implement a staff education program aimed at enhancing …

Building A Grounded Theory Of Resilience Among Survivors Of Chronic Ischemic Stroke, Erin Marie Tompkins Doan

Dissertations

Abstract

Stroke is disruptive with elusive recovery and adjustment. Beyond traditional aspects of stroke rehabilitation, literature suggests adjustment to stroke should also include intervention with focus on resilience. A gap exists between conceptualization, theoretical models, and strategies for supporting resilience in persons with chronic ischemic stroke. This three-manuscript dissertation research comprised a scoping literature review, a pilot study, and a phenomenological case study. We employed a convergent mixed methods design in which we implemented and studied outcomes of an adaptive mindfulness intervention. We implemented eight focus groups with eight adults and four individual interviews over 13 months. The Brief Resilience …

Optimizing The Psychiatric Referral Pathway Between Community Health Center Primary Care Partner And An Academic Medical Center Psychiatric Practice: Baseline Assessment Of The Current State And Needs, Katherine Verdier

Doctor of Nursing Practice Scholarly Projects

Background

The shortage of mental health professionals and the stigma associated with seeking mental health care has contributed to the need for primary care to provide mental health services. While primary care providers are well-placed to offer mental health treatment, they may not feel comfortable prescribing psychotropic medication in their practice. In the absence of full collaborative care models, consulting with psychiatric specialists can help primary care providers to manage mental health conditions in primary care.

Local Problem

At a community health center (CHC) in Worcester County, Massachusetts, primary care providers (PCP) provide mental health treatment for patients and have …

Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason

Walden Dissertations and Doctoral Studies

In this staff education initiative, I focused on fall prevention in long-term care facilities (LTCFs) by reinforcing the Morse Fall Scale fall risk assessment tool. Falls in LTCFs are a significant concern, leading to injuries, hospitalization, and declining residents' quality of life. The practice problem stems from insufficient staff training, contributing to inadequate patient care and an increased risk of falls. The practice-focused question was used to explore whether education about fall prevention measures and guidelines improves long-term care nurses’ knowledge and intent to follow these guidelines; a total of 23 participants were involved in this project. Pre- and post-education …

A Systematic Review Of Brief Cognitive Test Used Among The Veteran Population, Joel Mcpherson

Walden Dissertations and Doctoral Studies

The practice problem this DNP project addressed was the lack of a of consensus for a brief cognitive screening (BCS) tool that can be most predictive of mild cognitive disorder (MCI) and dementia in a Veteran Affairs (VA) outpatient clinic. Addressing this gap in practice is important because the veteran population may be at increased risk of MCI and dementia due to age, a history of traumatic brain injury, and posttraumatic stress disorder. This DNP project was a systematic review of the literature. A population, exposure, outcome (PEO) framework and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) theory guided …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

Crisis Without Cops: Trauma-Informed Mental Health Care For Bipoc Communities, Amanda Carson

Doctor of Nursing Practice Final Manuscripts

This policy paper advocates for a structural transformation in mental health crisis response, moving beyond police-led interventions toward trauma-informed, community-rooted models grounded in public health and equity. Drawing on Critical Race Theory (CRT), neuroscience, and program evaluations of models like CAHOOTS, 988, Denver’s STAR, and Durham’s HEART, it examines how systemic racism, institutional mistrust, and implicit bias contribute to disproportionate harm for BIPOC individuals. The paper highlights the effectiveness of peer-led, culturally responsive alternatives that reduce force, hospitalization, and disengagement from care. Using Kingdon’s Multiple Streams Framework, it proposes actionable, scalable policy strategies supported by recent federal momentum, including the …

Suprathel Burn Dressing Versus Standard Care: Impact On Hospitalization Duration And Post- Discharge Outpatient Visits, Isaac Awolola

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project is to determine the effectiveness of Suprathel a synthetic, one-time application, wound dressing that acts as a temporary skin substitute, particularly effective for partial-thickness burns and deep dermal burns vs, the standard of either Polysporin or Santyl, Xeroform, gauze on the frequency of outpatient (OP) visits after a patient’s discharge. A secondary aim of this project was to investigate whether Suprathel burn dressing significantly decreases the length of stay (LOS) for patients with second-degree burns involving < 20% total body surface area (TBSA). The results showed that the use of Suprathel dressings resulted in a shorter hospital stay 7.05 vs 9.35 days with a higher number of outpatient visits 5.47 vs 2.69 visits, compared to conventional dressings. The use of Suprathel dressings as a standard practice reduces inpatient hospitalization but increases outpatient visits and resource utilization. The use of Suprathel dressings shortens the length of hospitalization and may augment patient comfort, and decrease overall healthcare costs associated with hospitalization. Due to the reduction in need for painful daily dressing changes, Suprathel dressings constitute a potentially preferred option in burn care and could thereby influence treatment protocols and enhance patient outcomes.

Keywords: Wound care, Suprathel dressing, total body surface area, Outpatient Visits, Second-degree Burn, Length of stay, Gauze

Influence Of Nurse’S Knowledge And Attitudes On Caring Behaviors For People With Opioid Use Disorder, Inyene E. Essien-Aleksi, Don Roosan, Tracie Mcpadden, Leslie Rideout, Michael Martin, Paula-Jo Beniers, Amy Lund, Danielle Leone-Sheehan, Alysse Wurcel

Health Sciences Faculty Publications

Background: Opioid use disorder (OUD) remains the leading cause of preventable substance use-related deaths in the U.S. Each year, more than 1 million Americans seek hospital care for OUD-related issues. However, they often receive inadequate treatment and face barriers such as limited overdose prevention education, delays in medication initiation, and insufficient post-discharge follow-up. Nurses are well-positioned to improve inpatient OUD treatment, yet qualitative research suggests they often have limited knowledge and negative attitudes toward OUD, which can decrease the level of compassion and empathy nurses have toward people with OUD. Validated instruments, such as the Care Behavior Index (CBI-6) and …

Pain Management Educational Module For Nursing Staff, Kathyrina Lucy Pham

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in pain management among nursing staff in the rehabilitation unit. Frequent pain-related patient calls contributed to inconsistent clinical practices. This project aimed to evaluate whether a brief, evidence-based educational intervention could enhance nurses’ knowledge of pain management. 47 registered nurses participated in an educational module delivered during both day and night shifts. Pre- and post-test scores were collected and analyzed to assess knowledge acquisition. T-test results indicated a statistically significant improvement in nurses’ pain management knowledge. The findings support the effectiveness of brief, targeted education in promoting clinical outcomes …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

Remind: Raising Awareness Of Nurse Burnout Using An Educational Intervention, Emily Louise Missimer

Doctoral Dissertations and Projects

Burnout is an international occupational phenomenon that can negatively impact one’s physical, emotional, and psychological well-being. Although burnout affects all occupations, professionals working in the healthcare field are known to be at high risk for occupational burnout secondary to factors such as high-stress environments, critically ill patients, increased patient care requirements, frequent exposure to mortality, and shiftwork with long hours, among other factors. Of the subgroup of healthcare providers, it is also widely known that nurses who have a high exposure to death, such as hospice nurses, are at an even higher risk for occupational burnout. At a hospice care …

A Qualitative Study Of Registered Nurses’ Perceptions Of The Impact Communication Modalities Have On Patient Care Outcomes In Primary Care, Eleanor M. Chapital

Doctoral Dissertations and Projects

Communication plays a vital role in the provision of patient care and directly impacts patient care outcomes across the care continuum. The purpose of this qualitative study was to explore and determine registered nurses’ perceptions of the communication modalities that facilitate optimum patient care outcomes in the primary care setting. Registered nurses play a critical role in the provision and coordination of patient care. Therefore, it is imperative to study their experiences and perceptions to facilitate communication within primary care teams. The central research question for this study was the following: How do registered nurses describe their use of communication …

Evidence Based Orientation And Mentorship: A Solution To Decreased Job Satisfaction And Performance Amongst Healthcare Techs In The Emergency Department, Paige E. Fleming

Doctoral Dissertations and Projects

Healthcare technician support in high-volume emergency departments (EDs) is often inadequate, leading to challenges in job satisfaction, confidence, and competence. This project implemented an evidence-based orientation and mentorship program to enhance these factors among healthcare techs. Using a nonrandomized before-after design, participants underwent structured mentorship and orientation, with outcomes measured through pre- and post-intervention surveys, competency assessments, and feedback forms. Data analysis employed descriptive and inferential statistics to evaluate changes in job satisfaction, confidence, and competence. Results demonstrated measurable improvements in all three areas, supporting the effectiveness of structured mentorship in professional development and retention.

Undergraduate Nursing Students' Perceptions Of Faculty Mentorship For Student Success In Persevering Toward Program Completion: A Qualitative Study, Shirley C. Callihan

Doctoral Dissertations and Projects

The purpose of this qualitative exploratory single case study is to explore the undergraduate nursing students' perceptions of faculty mentorship for student success in persevering toward program completion. The theory guiding this study is the Roy Adaptation Model (RAM) by Callista Roy, as it relates to nursing students' adaptation to the challenges in their environment through faculty mentorship. The central question is: What are undergraduate nursing students' perceptions concerning faculty mentorship for student academic success in persevering toward program completion? Convenience sampling was used to recruit ten participants who were undergraduate nursing students from a Registered Nursing program in the …

The Perceived Effectivenss Of Nurses' Suicide Management Training In Correctional Facilities: A Phenomenological Study, Phillis Hopson

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the perceived effectiveness of nurses' suicide management training in correctional facilities in the United States. The central research question was: What suicidal educational training do nurses receive, and what is their lived experience of managing suicidal inmates at correctional facilities? The type of research design for this study was hermeneutic phenomenology. This study's geographic setting was two correctional facilities in rural areas in the United States. The settings include the Federal Mental Correctional Facility (FMCF) and the Villian Mental Correctional Facility (VMCF). The Federal Mental Correctional Facility is situated in the …

Implementation Of Social Support Assessment In Patients Aged 65 And Older With Type 2 Diabetes Mellitus To Improve Treatment Adherence In A Primary Care Setting, Angela Allen-Blaine

Doctoral Dissertations and Projects

Background: There is a growing number of adults aged 65 years and older living with type 2 diabetes. Research shows this population is at a higher risk of losing independence due to diabetic complications. Social support is a key component to help assist patients with taking medications properly, preparing diabetic meals and monitoring blood glucose. Adequate social support may improve the quality of health and well-being in older adults. Social support is not routinely assessed in primary care, but it is routinely treated. This evidence-based practice project aimed to educate clinicians about social support assessment and facilitate implementation of a …

Improving Patient Satisfaction With Discharge And Recovery Preparedness, Leanne N. Davis

Doctoral Dissertations and Projects

The Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS-CAHPS) survey is a standardized tool healthcare organizations utilize to measure patient perceptions of care. The survey results are linked to reimbursement by many insurers, making it prudent for health systems to work toward increasing patient satisfaction with their care. This evidence-based practice project followed the Iowa Model of Evidence-Based Practice to implement a quasi-experimental pilot that would determine whether providing written and verbal patient discharge education in both the preoperative phase of care and the postoperative phase of care compared to only the postoperative phase of care …

Clinical Practice Patient Education Guideline For Patients With Substance Use Disorders, Josephine Nandzo

Walden Dissertations and Doctoral Studies

The Veteran’s hospital for which this DNP clinical practice patient education guideline (CPPEG) was developed has made strides in addressing the needs of patients with substance use disorders (SUDs). However, the problem identified for this project was the need for veterans with SUDs to obtain information about resources available in the hospital, community, or state to manage their recovery. The project question was as follows: Will a CPPEG on resources for patients with SUDs meet the optimal threshold of 7 on the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument? The purpose was to plan, implement, and evaluate …

Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda

Walden Dissertations and Doctoral Studies

Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …

Policy Proposal For Integrating Pediatric Mental Health Into Nursing Practice In Uganda, Giselle S. Perez

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Mental health disorders affect over 1 in 7 individuals aged 10 to 19 globally. In low- and middle-income countries like Uganda, limited access to mental health specialists and pervasive stigma exacerbate the gap in care. Nurses, often the first point of contact, typically lack adequate pediatric mental health training. The proposal aims to address this gap by equipping nurses with the knowledge and competencies to identify, intervene, and support children with mental health disorders. Purpose: This proposal advocates for implementing targeted, continuing education in pediatric mental health for Ugandan nurses. The goal is to enhance the quality of …

Beyond The Bmi: An Educational, Family-Centered Approach To Identifying Risk For Childhood Obesity, Michelle J. Mak

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, the increasing prevalence of obesity has caused public health concerns. From 2017 to 2020, 14.7 million children ages 2 to 19 were considered obese. The main parameter for diagnosis is a body mass index (BMI) at or above the 95th percentile on the growth chart. Additionally, overweight is defined as a BMI between the 85th and 95th percentiles. At a pediatric primary care clinic in San Diego, CA, over a third of patients are considered overweight or obese. Obesity comorbidities can include type 2 diabetes, hypertension, and hyperlipidemia. Overweight adolescents have a 70% likelihood of …

From Fee For Service To Outcome Based Care: A Policy Proposal To Reduce Provider Burnout In Assertive Community Treatment, Amanda M. Thompson

Doctor of Nursing Practice Final Manuscripts

Purpose: This project examines the impact of the fee-for-service (FFS) reimbursement models on provider burnout within Assertive Community Treatment (ACT) programs and proposes a hybrid reimbursement framework that integrates case-rate and outcome-based payment structures. The goal is to enhance care quality, improve provider retention and optimize patient outcomes by addressing financial and administrative inefficiencies inherent in the current model.

Background: Mental illness affects over 59 million U.S. adults with serious mental illness (SMI) presenting significant challenges in healthcare delivery. ACT is an evidence-based, multidisciplinary approach designed to provide intensive, community-based psychiatric care to individuals with serious mental illness (SMI). However, …

Increasing Depression Risk Screening In Hospice And Palliative Care Patients, Elizabeth Kanini Michaels

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education project. The practice problem involved inconsistent depression risk screening in hospice and palliative care patients. It was crucial to address this, as depression can be pervasive in this population. The practice-focused question was, For registered nurses who work in a palliative or hospice care unit, does education on depression risk screening increase depression screening rates as compared 12 weeks before to 12 after the education? The project aimed to improve depression risk screening rates through staff education. The Johns Hopkins nursing evidence-based practice model was used to assess 13 supporting articles …

Staff Education To Improve Patient Outcomes And Treatment Compliance Through Use Of Motivational Interviewing In The Mental Health Setting, Rachel Nardi

Walden Dissertations and Doctoral Studies

Summary: Treatment noncompliance is a significant problem within the realm of mental health care. Recurrent noncompliance increases symptom severity, the likelihood of a crisis, and the burden placed on mental health care resources. Motivational interviewing (MI) is an evidence-based practice (EBP) demonstrated through extensive research to positively affect patient outcomes. Teaching MI to mental health care providers is one option organizational leaders can choose to address treatment noncompliance. In order for MI to become standard nursing practice, a method of education must be developed and implemented. This necessitates the identification of effective education delivery methods. A staff education project was …