Digital Commons Network^™

Improving Effective Communication: A Practice Centered Approach To Language Barriers In Mental Health Care, Cassandra Zhou

NURS 502: Critical Inquiry and Scholarship in Nursing Practice

To move towards equitable mental healthcare practices for non-English speakers, this paper aims to provide a comprehensive review on the current procedures regarding diagnosing and treating non-English speakers to better explore possible recommendations.

Guided Imagery: The Effects On Perioperative Anxiety And Postoperative Pain And Sleep Quality, Emma Webb

NURS 502: Critical Inquiry and Scholarship in Nursing Practice

Anxiety is the emotional and physiological response to stimuli perceived as threatening and is a common feeling experienced by many individuals in the time surrounding surgical operations (Gonzales et al., 2010). Perioperative anxiety has the potential to elevate pain levels, increase the prevalence of postoperative complications, and increase the duration of stay in the recovery period (Celik & Edipoglu, 2018). Guided imagery is a nonpharmacological intervention that utilizes visualization tactics to achieve a state of relaxation, and is an effective method for improving mind-body healing processes (Topan et al., 2024). While guided imagery has been found to impact pain, stress, …

Nurses’ Perceptions And Expectations Of Patient Violence: Language Matters, Darcy Copeland, Mary Potter, Susan Tipton, Debra Culter

Nursing Faculty Publications

Background: Patient violence is a serious occupational risk for nurses. Some professional rhetoric presents this risk as not part of nursing work, discounting widespread exposure. There is a disjunction between nurses’ experiences and the discourse they are exposed to. There is little to no evidence indicating whether nurses think it is possible to eliminate patient violence or whether their expectations of exposure to patient violence align with the significant risk they face. Purpose: The purpose of this analysis was to examine nurses’ perceptions related to the elimination of, expectations of, and desired state regarding exposure to patient violence. Methods: This …

Experiences Among Parents Caring For Children With Juvenile Idiopathic Arthritis At A Tertiary Referral Hospital In Kenya, Hassan Silim, Susan Wamithi, Roselyter Riang’A, Angela Migowa

Paediatrics and Child Health, East Africa

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Despite the availability of effective treatment strategies such as disease-modifying antirheumatic drugs (DMARDs), JIA is reported to have a negative impact on the quality of life of the patients and their caregivers. Ascertaining the perceptions of the parents will help facilitate more effective management strategies and improve outcomes for these patients. This study aimed to ascertain parental experiences and perceptions of caring for children with juvenile idiopathic arthritis (JIA).

Methods: This was a single-center facility-based qualitative study. An in-depth interview guide was used to collect …

The Swahili Version Of The Cd-Risc 10 Resilience Scale: Psychometric Properties And Factors Associated With Resilience Among Healthcare Workers In Tanzania, Kevinson Mwangi, Sabina Odero, Gideon Mbithi, Rachel Odhiambo, Rosemary Stephen, Tumbwene Mwansisya, Eunice Pallangyo, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Despite the central role of resilience in promoting mental well-being, little is known about the resilience process among healthcare workers in East Africa, partly due to the lack of adequately standardised and psychometrically sound assessment tools for our context. This study provides the first psychometric evaluation of the Swahili version of the Connor-Davidson Resilience Scale 10 (CD-RISC 10) among nurses/midwives and community health volunteers (CHVs) in Tanzania, potentially informing the accuracy of measuring resilience in this setting. Additionally, we examine factors associated with self-reported resilience as measured by the CD-RISC 10 scale.

Methods We used cross-sectional data on nurses/midwives …

Mental Health Screening And Its Effects On Obese And Overweight Patients: Quality Improvement Project, Amanda Ivos

DNP Projects

Obesity is a growing, multifactorial epidemic. The CDC recommends a 5% weight reduction in order to prevent potential complications associated with overweight or obese status. Mental health, particularly depression, contributes to weight issues with obese individuals having an 18% greater risk of depression, and those with depression having a 37% greater risk of obesity. Both conditions may increase the risk of cardiovascular disease and mortality. Evidence suggests screening and managing depression in overweight/obese patient may lead weight loss and better health outcomes in this patient population.

Project Goals

1. To improve weight loss outcomes in obese or overweight patients with a …

Effects Of The Vitality Acupunch Exercise Program On Older Adults With Probable Sarcopenia: A Mixed Methods Pilot Study, Brittany Murley, Kuei-Min Chen, Christine S. Gipson, Kevin Gosselin, Jenna Thornhill, Allison Ross, Kennedy Gladding, Beth Mastel-Smith

Nursing Faculty Publications and Presentations

Purpose: Age-related loss of muscle mass and strength is a highly prevalent condition in older adults in long-term care (LTC) facilities. This pilot study aimed to test the effects of a vitality acupunch (VA) exercise program on muscle mass, muscle strength, muscle endurance, functional fitness, activities of daily living, quality of life, and sleep quality of older adults in LTC facilities with probable sarcopenia in the United States and understand the experiences of residents who participated in the VA program. Design: A mixed-methods experimental design was used for this study. Methods: The quantitative phase included a sample of 27 participants …

The Predictors Of Success For Pre-Licensure Bsn Students: An Exploratory Analysis Of Assessment Methods, Nihimu Nkechinyere Evulukwu

Doctor of Nursing Practice Projects

Background

Success in the National Council Licensure Examination (NCLEX-RN) on the first attempt is essential for continued program accreditation, sustainability, and maintaining the national nurse workforce. Admission policies and assessment methods contribute to student enrollment and success. This Doctor of Nursing Practice (DNP) project evaluated the admission requirements of cognate and overall GPAs and assessment requirements of Health Education System Incorporated (HESI) scores in the School of Nursing to determine the best predictors of the first-time NCLEX-RN pass rates. This project aimed to determine whether the use of admission requirements in the School of Nursing Bachelor of Science in Nursing …

Management Of Aggressive And Disruptive Behavior In The Emergency Department Using De-Escalation Techniques And Simulation: A Quality Improvement Project To Improve The Knowledge And Confidence Of Emergency Department Nurses And Clinical Staff, Ernestine Darby-Littlejohn

Electronic Theses and Dissertations

Abstract

Approximately 40% of all healthcare workers have reported episodes of violence by patients over the last 2 years. This Veteran’s Health Agency reported 824 disruptive events reported in the last 5 years, of which 56 occurred in the emergency department. Research shows that interventions are not always timely, resulting in the clinical staff requesting the Veteran’s Health Agency Police to intervene when a veteran’s level of stress is escalating. The gap in practice is shown to be related to a lack of knowledge in the clinical staff in managing high stress levels exhibited by some veterans, limited knowledge of …

Integrated Mental Health Care In Specialty Clinics For Children With A Diagnosis Of Asthma Or Diabetes: A Mixed Methods Study, Joan P. Totka, Maria Peña, Joshua A. Steinberg, Peter M. Wolfgram

College of Nursing Faculty Research and Publications

Introduction

Using patient-reported outcome measures (PROM) in a shared-space mental health-integrated specialty clinic, we explored the feasibility, acceptance, and experience of youth with asthma and diabetes, their families, and the healthcare team.

Method

Using mixed methods, we examined feasibility, acceptability, and experience of PROM inclusion in caring for youth with asthma (n = 7) and diabetes (n = 11), their families (n = 18), and healthcare providers (n= 13). Completion and receipt of PROM (feasibility), postvisit surveys (acceptance), and structured interviews (experience) between June 2019 and February 2020.

Results

Targeted PROM met feasibility goals (80%) …

Implementing An Exercise Program In Prediabetic Patients On Glp-1 Ras To Increase Self-Efficacy And Decrease Hgba1c, Bmi, And Weight, Tamara Alston

Doctoral Dissertations and Projects

Obesity is a significant factor in the progression from prediabetes to type 2 diabetes mellitus. Obesity is a condition of excess adipose tissue caused by an imbalance between the calories a person takes in, the absorption of those calories, and energy expenditure or how many of those calories a person burns. In 2022, the total cost of care for people with diabetes was $413 billion. Evidence indicates increased physical activity is directly associated with weight loss and decreased waist circumference. The literature supports that 150 minutes of weekly exercise can reduce HgbA1c, weight, and body mass index. Additionally, improved self-efficacy …

The Clinical Impact Of A Standardized Pathway For Chest Pain Evaluation In The Urgent Care Setting, Tysheena L. Jones

Doctoral Dissertations and Projects

This study aimed to evaluate the deficiencies in the current chest pain evaluation practices compared to standard of practice at urgent care centers and to develop an evidence-based clinical workflow prioritizing the reduction of the door-to-EKG times utilizing the Marburg heart score assessment tool. Conducted in three urgent care centers within a larger not-for-profit healthcare system, the retrospective pretest-posttest design involved 44 patients presenting with chest pain. Utilizing t-tests, the study found a significant reduction in door-to-EKG times from 39 minutes pre-intervention to 14 minutes post-intervention (p < 0.05). The pre implementation chart reviews revealed that 7 (32%) of the charts had the required risk assessment tool used, and score documented in the EMR. The post implementation chart reviews revealed that 6 (27%) of the charts had the required risk assessment tool used and score for chest pain documented in the EMR. The Marburg Heart Score facilitated timely identification of high-risk patients while minimizing unnecessary EKGs for low-risk individuals, though protocol adherence and external workflow disruptions were noted limitations. The findings underscore the importance of standardized workflows in enhancing care efficiency and patient outcomes, suggesting that future research explore long-term sustainability and broader implementation in urgent care settings.

A Nursing Education Intervention In An Adult Inpatient Setting To Improve Compliance Rate With Pressure Injury Prevention Intervention, Brooklynn Jane Janke

Doctoral Dissertations and Projects

Pressure injuries can lead to life-threatening health complications for patients and cause physical, psychological, and financial stress to patients suffering from them. The literature review demonstrated that bedside nursing staff often have not received the appropriate education about pressure injury prevention and care. The literature review also revealed that nurses prefer to be educated one-on-one and peer-to-peer. Therefore, providing focused and frequent education on pressure injury prevention and improving nurses’ understanding of the importance of pressure injury prevention can improve the quality of care a nurse provides, and patients receive, thus reducing the number of health care-acquired pressure injuries. The …

The Differences In Perceived Stress And Coping For Prelicensure Nursing Students After A Positive Reappraisal Coping Intervention, Deanna Lynne Walborn

Doctoral Dissertations and Projects

Academic stress has become a common problem among nursing students, which can lead to undesirable student outcomes if their stress goes unabated. The purpose of this quasi-experimental pretest/posttest study is to determine if an intervention using a positive reappraisal coping intervention (PRCI) can reduce student nurse stress. Knowles’ theory of adult learning along with Lazarus and Folkman’s transactional model of stress and coping (TMSC) provided a foundation for the study. Olejnik’s (1984) table was used to determine the minimal total sample size required for this research. A sample of 26 nursing students from those who are enrolled in a public …

Building Capacity For Trauma-Informed Care: Enhancing Knowledge, Attitudes, And Practice Of Trauma-Informed Care Among Nurses, Kim G. Cudjoe

Doctoral Dissertations and Projects

Exposure to trauma is a global and pervasive phenomenon that is known to have negative consequences on the health, health outcomes, and well-being of individuals and at-risk populations to include Veterans. The implementation of trauma-informed care concepts and principles in the delivery of healthcare services among all staff and across the span of healthcare allows healthcare professionals to realize the impact of trauma on individuals, to recognize the signs and symptoms of trauma, to respond to trauma through improved practices, procedures, and policies; and to prevent re-traumatization while receiving care. The purpose of this evidence-based project is to develop and …

A Standardized Approach To Patient Teaching Regarding Medication Adherence For Schizophrenic Patients, Ifeanyi Christian Onye

Walden Dissertations and Doctoral Studies

Medication nonadherence in schizophrenic patients is one of the most challenging facets of mental healthcare management. This chronic problem affects leads to worsening symptoms and a higher hospitalization frequency. This project was a staff education project designed to address the practice problem of knowledge deficit of staff regarding medication adherence for schizophrenic patients. The practice-focused question was “Does staff education on a standardized approach to medication adherence provide increased knowledge and ability of the staff in the support of schizophrenic patients?” The practice question addresses identified gaps in nursing knowledge and lack of defined teaching standards for the improvement of …

Staff Education On Phq-9 Screening Tool Implementation, Sweetie Hope Doychinov

Walden Dissertations and Doctoral Studies

The purpose of this DNP project was to evaluate whether a staff education program could measurably improve healthcare professionals' knowledge of the Patient Health Questionnaire-9 (PHQ-9) for depression screening at the practicum site. Depression remains underdiagnosed in primary care, largely due to inconsistent use of standardized tools like the PHQ-9, which is essential for timely diagnosis and treatment. This project addressed this gap by educating healthcare staff on the administration, scoring, and integration of the PHQ-9 into patient care, thereby enhancing their confidence and competence in its consistent application. The practice-focused question was the following: For healthcare staff at an …

Staff Education For Intake Clinicians On A Behavioral Health Unit At A 137-Bed Safety Net Hospital In An Underserved Community, Latisha Stennis

Walden Dissertations and Doctoral Studies

Mental health conditions among adolescents are rising across the nation. This project consisted of an educational intervention implemented at a 137-bed safety net hospital that is expanding psychiatric services for adolescents, and numerous personnel at the organization reported having limited knowledge and experience working with this population. The project aimed to reduce the knowledge gap by accentuating the signs and symptoms of adolescents with anxiety, depression, suicidal, and self-injurious behaviors. The practice question that was developed to address this problem was as follows: Does implementing an educational intervention focused on adolescent anxiety, depression and recognizing suicidal and self-injurious behaviors enhance …

Workplace Violence Prevention, Solomon Soroibe Okwueze

Walden Dissertations and Doctoral Studies

This staff education and quality improvement project was created to reduce workplace violence incidents within a psychiatry and primary care health group. Research has shown that the frequency of workplace violence events can create a critical practice problem that severely impacts the safety, morale, and, ultimately, retention of nursing staff. Addressing workplace violence in the healthcare field not only can ensure a safer working environment but also can increase the well-being of staff and assure high-quality care for patients. The project highlights a proactive approach to mitigating violence, promoting safety culture, and improving workplace ambiance. The central practice-based question guiding …

Breastfeeding Interventions And Programs Conducted In The Islamic Republic Of Iran: A Scoping Review, Patricia J. Kelly, Amrita Sidhu, Anusha Sajja, Devanshi Majeethia, Elizabeth Dodge, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

The purpose of this review was to identify interventions promoting breastfeeding (BF), BF practices and their outcomes in Iran. Using the PRISMA-ScR Guidelines, we searched across 14 databases for publications published between 2010 and February 2024 to identify studies published in English or Farsi language in peer-reviewed journals, using search terms 'breastfeeding', 'lactation', 'education', 'promotion', 'intervention' and 'program'. Inclusion criteria included intervention-based studies with quantitative outcomes of pregnant women/mothers receiving education, training or other intervention that promoted BF or exclusive BF. Excluded studies were protocols, those examining Iranian communities outside of Iran publications in other languages, brief communications, gray literature …

Executive Summary: Staff Education Project Reducing Burnout Through Mindfulness Education, Shateria Michelle Boone

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice (DNP) project focused on addressing burnout for staff nurses working in a psychiatric hospital. Evidence indicated that burnout among nurses, caused by emotional stress and heightened responsibilities, may result in increased medical errors, diminished patient satisfaction, and significant dangers to patient safety and care. The practice-focused question for this project addressed whether a mindfulness-based educational intervention program would increase staff knowledge and decrease burnout among nurses working in a psychiatric hospital. The program incorporated a pretest/posttest format, educational content delivered via a PowerPoint presentation that included an interactive mindfulness meditation training session, and a …

The Generalized Anxiety Disorder 7-Item (Gad-7) Tool For Anxiety Screening, Nicholas Tindong

Walden Dissertations and Doctoral Studies

The staff education project aimed to address the gap in practice regarding the use of the Generalized Anxiety Disorder 7-item (GAD-7) screening tool at a psychiatric clinic. Approximately 40% of the clinic’s patients exhibited symptoms of generalized anxiety disorder (GAD), yet the nurses did not consistently use validated tools to assess anxiety severity, relying instead on unstructured clinical interviews. This inconsistency has resulted in delayed diagnoses and suboptimal patient care. The project sought to improve nursing staff's knowledge and confidence in using the GAD-7 tool through a structured education program guided by the following practice-focused question: Among nurses at a …

Staff Education On Medication Nonadherence For Patients With Bipolar Disorder, Julius Chick Abam

Walden Dissertations and Doctoral Studies

Summary From both the literature and the staff observation in this private practice, bipolar disorder (BD) patients who do not comply with medication are at a higher risk of hospitalization and poor quality of life. The purpose of the project was to implement staff training focused on adherence strategies, including motivational interviewing and psychoeducation to improve medication adherence rates among BD patients. The project question was: Does providing an interactive education program using case studies improve staff knowledge and self-confidence? Different studies support the effectiveness of both psychoeducation and motivational interviewing in improving adherence and functionality in BD. An interprofessional …

The Effectiveness Of Naloxone Staff Education In Reducing Opioid Overdose Mortality Among Young Adults In An Outpatient Behavioral Clinic, Taiwo Oguntade

Walden Dissertations and Doctoral Studies

The Naloxone Staff Education Project was implemented within an outpatient behavioral health practice to address the critical issue of insufficient staff education regarding Naloxone use in opioid overdose responses. Opioid overdoses, particularly among young adults, have become a leading cause of preventable death, with nearly 108,000 deaths recorded in 2022, 76% of which involved opioids. The project aimed to assess the impact of Naloxone education on staff knowledge, competency, and confidence in responding to opioid overdoses among patients aged 18 to 35. Utilizing pre- and post-education assessments, including surveys and interviews, the project evaluated staff readiness to administer Naloxone. Results …

Executive Summary: Educating Staff On The Use Of The Columbia Suicide Severity Rating Scale, Muktar Trawalley

Walden Dissertations and Doctoral Studies

Suicidal ideation is a serious public health concern among individuals, especially in the United States. The Columbia-Suicide severity rating scale (C-SSRS) is the tool used to assess the severity and frequency of suicidal ideations. The gap in practice at this site is that mental health providers lack knowledge of using the C-SSRS. This evidence-based educational project aimed to improve nursing knowledge on using the C-SSRS in a psychiatric mental health facility. A practice-focused question was developed: Among psychiatric nurses in an outpatient mental health facility, does staff education on C-SSRS improve their knowledge of its application over 8 weeks, as …

Nurse Experiences Of Caring For Children With Autism Spectrum Disorder In Los Angeles Pediatric Intensive Care Units, Makenna Brown

Walden Dissertations and Doctoral Studies

One in 22 California children is diagnosed with autism spectrum disorder (ASD). In combination with sensory considerations, healthcare costs, and increased healthcare utilization, these children face a lesser quality of care and poorer health outcomes. The literature addresses healthcare needs and experiences from various viewpoints, but does not address the experiences of nurses (RN) caring for children with ASD in the pediatric intensive care unit (ICU). The purpose of this study was to gain an understanding of RN’s challenges, and the helpful strategies utilized in practice. A qualitative, grounded study approach, centered on the patient-and-family centered care conceptual framework, was …

Executive Summary: Clinical Practice Guideline Primary Care Management Of Overweight/Obesity In Adult Women, Getrude Tate Nguatem

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a clinical practice guideline project focused on overweight and obesity management of adult women in primary care. The practice problem identified was the lack of an evidence-based clinical practice guideline to manage overweight/obesity in adult women. It was important to address this problem because overweight and obesity were significant health concerns at this clinical site in the United States and the world. The practice-focused question was the following: “Does the evidence support the development and Appraisal of Guideline for Research and Evaluation (AGREE) II instrument quality scoring of a clinical practice guideline on …

Staff Education To Improve Phq-9 Depression Screening In Primary Care, Adella Kweyila

Walden Dissertations and Doctoral Studies

The staff education project aimed to address the gap in practice regarding the use of the PHQ-9 depression screening tool in a primary care setting. The providers at the setting demonstrated variations in screening practices leading to potential missed opportunities for early depression identification and treatment. This Doctor of Nursing Practice project explored the question: “What is the effect of implementing a staff education program to improve staff knowledge to effectively implement changes that affect the use of the PHQ-9 screening tool to improve depression identification and treatment of adult patients in a primary care clinic?” This project aimed to …

The Experience Of Genetic Testing Among Latinas With Brca1/2 Mutation, Lisania Milli

Seton Hall University Dissertations and Theses (ETDs)

Healthy women with BRCA1 (BReast CAncer gene 1) or BRCA2 (BReast CAncer gene 2), (henceforth, BRCA1/2 mutation) without a diagnosis of breast or ovarian cancer (unaffected), have up to 80% increased lifetime risk of developing breast cancer, and up to 40% increased lifetime risk of ovarian cancer. Genetic counseling and testing based upon family history is essential to diagnose genetic mutations increasing one’s risk for certain cancers. Latinas have the second highest prevalence of BRCA1/2 mutations after Ashkenazi Jewish women, and cancer is now the leading cause of death among Latinos, surpassing cardiovascular disease. However, no qualitative study has been …

Promoting Consistency In Phq-9 Depression Screening For Young Adults In An Outpatient Mental Health Clinic., Abena V. Prempeh

Walden Dissertations and Doctoral Studies

This project aimed to improve the consistency of PHQ-9 depression screenings for young adults in an outpatient mental health clinic. Through the implementation of standardized protocols and staff training, the goal was to reduce variability in screening outcomes. The evaluation method of the project involved staff interviews, surveys, and comparing pretest and post-test results to measure staff knowledge and confidence improvements. The results showed that there were significant improvements in staff knowledge and confidence. This project highlights the importance of standardized procedures in improving mental health care for young adults.