Digital Commons Network^™

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.

Enhancing Staff Impact On Medication Adherence In A Mental Health Outpatient Clinic, Uzoamaka Lynda Mbadugha

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project addressed the critical issue of medication nonadherence among mental health patients by implementing a staff education program at an outpatient clinic in the Mid-Atlantic region USA. The program focused on enhancing staff knowledge and confidence through training in psychoeducation, motivational interviewing, and multidisciplinary collaboration. Nonadherence often leads to relapse, hospitalization, and poor outcomes, compounded by a lack of structured interventions at the project site. Sixteen clinic staff members participated in biweekly training sessions over a one-month period. Pre- and post-training assessments revealed a 44.79% increase in staff knowledge and a 50% improvement in confidence …

Improving The Consistency And Accuracy Of Depression Screening Using The Phq-9 In A Behavioral Health Facility, Adaku Anike

Walden Dissertations and Doctoral Studies

Depression is one of the most common psychiatric illnesses and one of the main causes of disability globally. Currently, at behavioral care facility patients are not consistently screened during the initial and follow-up visits due to limited staff knowledge in using the Patient Health Questionnaire-9 (PHQ-9) screening tool. Evidence-based literature recommends depression screening be done at every initial and follow-up visit. The PHQ-9 tool is valid and reliable for identifying, diagnosing, and monitoring depression treatment outcomes. Inadequate use of the PHQ-9 tool can lead to several negative patient outcomes. The project practice-focused question was: Does comprehensive education increase the knowledge …

An Educational Intervention Focused On The Care Of Older Adults, Michele Orzehoski

Walden Dissertations and Doctoral Studies

It is estimated that by 2050, individuals ages 65 and older will comprise 20% of the U.S. population. Further, research has demonstrated that among these aging adults, 80% have one chronic condition with 77% having at least two chronic conditions. Given this, the Institute for Healthcare Improvement (IHI) developed the Age-Friendly Health System framework for the care of older adults centering on what matters, medication, mentation, and mobility, or the 4Ms. In the local organization, leadership determined there was a need for an older adult-centered care model given their population includes aging individuals. Thus, the purpose of this doctor of …

Developing The Evidence-Based Plan To Implement The Violence Assessment Tool, Yue Zhang

Doctoral Dissertations & Projects

Patient violence against healthcare workers is a prevalent issue in healthcare settings, manifesting through physical assaults, harassment, intimidation, or other disruptive behaviors occurring at the workplace. Workplace violence (WPV) can lead to healthcare worker burnout, decreased job satisfaction, and increased staff turnover. Various strategies exist to prevent WPV, with assessment tools being among the effective measures. This paper aims to develop an evidence-based plan for integrating the Violence Assessment Tool (VAT) into nurses’ daily practices to evaluate patients and reduce the risk of violent incidents.

Noise Reduction In The Operating Room, Riley Ebenroth, Anthony Barker

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Excessive noise levels in the operating room (OR) have serious detrimental effects on both patients and providers, such as acoustic trauma, increased heart rate and blood pressure, angina, surgical site infection, fatigue, mental stress, and anxiety. There is currently no set standard endorsed for OR noise levels in the United States. Purpose: The purpose of the project was to reduce noise in the OR which has been shown to impair concentration and communication as well as to determine whether an educational intervention will reduce the average OR noise levels within a surgical case.

Methods: This …

Adding Video Teaching To The Standard Of: Oral And Written Discharge Instructions, Pamela Austill Harris

Doctoral Dissertations and Projects

Adding video education to a patient’s discharge instructions on a rehabilitation unit of a skilled nursing facility (SNF) is researched for its use in decreasing the 31-day readmission rate from the community back to the hospital or SNF. A quasi-experimental method was used. There was a mean of 6 readmissions per month before the video intervention and during it was 0.6. Adding video education may be useful in an SNF to decrease the readmission rate from the community back to the hospital after discharge.

Awareness Of Sleep Health In A Military Treatment Facility, Cristina Brock De Jesus

Walden Dissertations and Doctoral Studies

Sleep disturbances are reported in almost one-third of military personnel deployed in support of Overseas Contingency Operations (OCO), resulting in approximately 600,000 military personnel and veterans with clinically relevant sleep conditions (Mysliwiec et al., 2013). This study assesses how implementing staff education will increase awareness and impact patients' sleep health in an overseas treatment facility. The project demonstrated after implementing several staff education courses for the nursing personnel (n=22), knowledge and confidence improved by 33%. The initiative shows an enhanced staff understanding of sleep health, which impacts the recognition of sleep members with sleep-related concerns.

Nurse Educators’ Experiences With Medical Cannabis Education, Rachel Ann Parmelee

Walden Dissertations and Doctoral Studies

Medical cannabis is legal in more than half of the United States, and the National Council of State Boards of Nursing has provided guidelines indicating that nurses need to know about medical cannabis. However, most nurses report a lack of knowledge and education but believe that cannabis has therapeutic potential. The problem addressed in this study was the limited research on nurse educators’ experiences with medical cannabis education and its meaning for nursing education. The purpose of this hermeneutic phenomenological qualitative study, supported by an emergent framework, patterns of knowing, was to explore nurse educators’ experiences with medical cannabis education …

School-Based Protective Factors For Hiv Prevention In The United States: Secondary Analysis Of The Youth Risk Behavior Survey 2015-2019, David R. Garcia, Jason Fletcher, Lloyd Goldsamt, David L. Bell, Yaguang Zheng, Ann-Margaret Dunn Navarra

School of Nursing Faculty Publications

This secondary analysis of the National Youth Risk Behavior Survey (years 2015-2019) examines associations between school-based protective factors (i.e., safe school environments and academic achievement) and HIV risk behaviors among sexually experienced adolescent gay and bisexual men ( n = 644), a population with the highest prevalence of undiagnosed HIV infections. Demographics included Hispanics/Latinos (25%, n = 158), Other race/ethnicity (14%, n = 88), and non-Hispanic Blacks/African Americans (13%, n = 81). Adjusted models showed that protective factors reduced odds for early sexual debut, multiple sexual partners, sex under the influence of drugs/alcohol, and condomless sex, with an additive effect …

The Impact Of Continuous Glucose Monitor Education On Primary Care Providers Prescribing Behavior, Heather Tyson

Doctor of Nursing Practice Projects

Continuous glucose monitors (CGMs) estimate glucose levels in the interstitial fluid, updated every few minutes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, CGMs are used by patients with Type 1 diabetes. However, research demonstrates that patients with Type 2 diabetes can also benefit from their use. The primary function of CGMs is to enhance glucose management, provide emergency alerts, and reduce the need for frequent fingerstick evaluation, promoting better long-term health. CGM use has lowered hemoglobin A1C levels in the primary care setting. This is due to the correlation between frequent glucose monitoring and increased …

Support Needs For Registered Nurses To Bachelor Of Science In Nursing Students In Kenyan Universities, Gladys Mbuthia, Gisela H. Van Rensburg, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Higher percentages of the registered nurses (RN) workforce with a bachelor's degree have been associated with better patient outcomes. RN with a diploma in nursing who are upgrading their qualifications to a bachelor's degree in nursing enter universities in Kenya as mature and part-time students. Studies have shown that mature and part-time students in universities have a higher attrition than their full-time peers. They are less likely to access extra support and personal development opportunities available at university, have a history of campus isolation, and fewer opportunities to engage with campus peers. The purpose of the study was to explore …

Evaluating The Efficacy Of Diabetes Nurse-Led Health Coaching Intervention For Type 2 Diabetes At Aga Khan University Hospital, Nairobi: A Randomised Controlled Study, Jane Mugo

MSc in Advanced Practice Nursing

Background: Type 2 Diabetes (T2DM) has placed a significant burden on both healthcare systems and individuals living with the disease. However, it is preventable through health promotion strategies. Healthy behavior changes, which improve disease outcomes, highlight the importance of supporting and sustaining self-efficacy in diabetes self-management.

Objective: This study aimed to test the effectiveness of a nurse-led health coaching program on diabetes control for individuals with T2DM with HbA1c >6.5% specifically on glycated haemoglobin (HbA1c) levels as compared with standard diabetes care only.

Methodology: The study adopted a randomized controlled trial (RCT) with two groups: an intervention group receiving the …

Knowledge, Attitude, And Practices Of Nurses Providing End-Of-Life Care At Aga Khan University Hospital, Nairobi County, Eunice Wanjiku Kariuki

MSc in Advanced Practice Nursing

Introduction: End-of-life care is an essential aspect of healthcare, and nurses play a vital role in its provision. Due to the growing population, there has been an increase in the number of people in need of End-of-life care, and nurses must be adequately prepared to meet the complex and diverse needs of patients and their families. However, many studies suggest that many nurses feel unprepared to provide quality end-of-life care, and there is a need for further investigation of the factors that contribute to their preparedness.

Methods:The study was conducted at a level 6 teaching and referral hospital, in …

Amplifying Women's Voices In Menopause Research: The Importance Of Inclusive Perspectives, Camille Cronin, Sara Donevant Phd, Rn, Ccrn, Kerri Ann Hughes, Marja Kaunonen, Jette Marcussen, Rhonda Wilson

Publications

Menopause, a significant life transition for half the global population, intersects biological, cultural and social dimensions. Despite its universal occurrence, menopause research has historically been dominated by biomedical perspectives, often neglecting women's voices and diverse experiences. This article highlights the importance of including women's perspectives in menopause research to ensure relevance, accuracy and equity. It explores cultural variations in menopause experiences, the impact of socioeconomic status and the often-overlooked emotional and psychological dimensions. This article advocates for participatory approaches, emphasising that women's involvement enhances research design, implementation and policy development. Evidence-based interventions that are tailored to the individual can better …

Creating Seamless Transitions To Manage Type 1 Diabetes In Emerging Adult College Students, Carol Newton Highsmith

Journal of Research Initiatives

Type 1 Diabetes (T1D) is a complex disease that can be challenging to manage in the college environment. An effective communication strategy is vital to ensure that first-year students entering college with T1D take advantage of campus resources for self-management and self-advocacy. This qualitative study examined the perceptions of academic healthcare professionals regarding the availability and gaps in services for students with T1D at higher education institutions. Using a phenomenological approach, semi-structured interview questions were posed to 17 service providers employed in health and wellness (n=9), nursing (n=4), and student support services (n=4) at 4-year universities. The findings revealed three …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Understanding The Impacts Of Surgical Drains On Postoperative Pain And Quality Of Life, Goutam K. Gadiraju, Matthew R. Prospero, Finn Tobias, Andrew J. Malek, Erik Reiche, Justin M. Broyles

School of Medicine Faculty Publications

Background: Surgical drains are commonly used in breast surgery and breast reconstruction for seroma prevention. Although many surgeons are aware that surgical drains can cause considerable discomfort to patients, less is understood about the specific impacts of drains on postoperative pain and quality of life (QOL). Methods: A cross-sectional survey was conducted among patients at our institution who had previously undergone mastectomy or breast reconstruction procedures to better understand patients' experiences with surgical drains. Patients were asked to report their attitudes toward a series of QOL statements and rate postoperative pain using numeric pain scales. Pair-wise analysis was used to …

Reducing Alarm Fatigue, Christina Smith

2025

Alarm fatigue refers to the phenomenon of excessive alarms in the healthcare system leading to staff ignoring or not hearing alarms that need clinical intervention (Bosma & Christopher, 2023). Healthcare staff experiencing alarm fatigue and desensitization leads to patient harm events up to and including death (Dee et al., 2022). Several interventions have proven effective to reduce non-actionable alarms or alarms that do not require action by the clinician. Combining these evidence based interventions into a bundle of nurse led interventions provides increased effectiveness in reducing alarm fatigue. This evidence-based practice (EBP) project aimed to evaluate the effectiveness of bundle …

Amplifying Women’S Voices In Menopause Research: The Importance Of Inclusive Perspectives, Camille Cronin, Sarah B. Donevant Phd, Rn, Ccrn, Kerri-Ann Hughes, Marja Kaunonen, Jette Marcussen, Rhonda Wilson

Faculty Publications

Menopause, a significant life transition for half the global population, intersects biological, cultural and social dimensions. Despite its universal occurrence, menopause research has historically been dominated by biomedical perspectives, often neglecting women's voices and diverse experiences. This article highlights the importance of including women's perspectives in menopause research to ensure relevance, accuracy and equity. It explores cultural variations in menopause experiences, the impact of socioeconomic status and the often-overlooked emotional and psychological dimensions. This article advocates for participatory approaches, emphasising that women's involvement enhances research design, implementation and policy development. Evidence-based interventions that are tailored to the individual can better …

The Experience Of Transition To Self-Management For Saudi Adolescents With Type I Diabetes, Aeshah M. Almulhim

Dissertations

In Saudi Arabia (SA), between 2011 and 2021, there has been a 108% increase in death rates due to diabetes. Every year, around 3,800 Saudi children and adolescents under the age of 19 are diagnosed with Type I Diabetes (TIDM). Saudi adolescents with TIDM have less glycemic control than adults and younger children. If left untreated, inadequate glycemic control may hasten the onset of diabetes complications and early death. As adolescents with TIDM grow older, they are expected to take on more independence in Self-Management (SM) of their diabetes. The poor clinical outcomes of adolescents with diabetes, the onset of …

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …

Correlation Of Physical Activity With Vasomotor, Psychosocial, And Physical Symptoms Of Menopausal Women In A Rural Area Of Pati Regency, Indonesia, Shovia Nurul Hidayati, Winarni Winarni

Journal of Asian Midwives (JAM)

Background: Menopause often brings vasomotor, psychosocial, and physical symptoms that challenge women's well-being, yet physical activity offers a promising avenue for relief. Physical activity can improve a person's quality of life. Menopausal women in Pegandan village have varying physical activity and menopausal symptoms but it is currently unknown whether they are correlated. This study investigated the correlation between physical activity and vasomotor, psychosocial, and physical symptoms among menopausal women.
Methods: The study employed a cross-sectional design involving 47 menopausal women from Posyandu Lansia in Pegandan village, Pati regency, Indonesia. They were selected by simple random sampling. Participants' measurements for physical …

The Role Of Maternal Position During The Second Stage Of Labor On Reducing Perineal Injury: An Integrative Review, Ericka L. Dalton, Tabatha Ruth Erlandson

All Electronic Theses and Dissertations

Introduction: Perineal lacerations remain a common occurrence amongst vaginal deliveries. While there are some recommendations for supportive techniques throughout the literature, position is typically not included in these. Perineal trauma can have a lasting effect on the individual and increase health care costs. The purpose of this review is to identify what birthing positions are most effective at preventing perineal injury.

Methods: A formalized search of the literature was conducted via PubMed, CINAHL, Google Scholar, and SCOPUS databases. Of the 344 articles identified, 22 original studies met the inclusion and exclusion criteria for this review. A literature matrix and quality …

Facilitators And Barriers To Interprofessional Collaboration Between Physicians And Midwives: An Integrative Review, Kathy D. Lambright, Anesha E. Martin

All Electronic Theses and Dissertations

Introduction: Early models of interprofessional collaborative care suggest that when there is a collaboration between midwives and physicians, the outcomes for mothers and babies are improved. The purpose of this integrative review of the relevant literature is to identify the facilitators and barriers to collaborative relationships between physicians and midwives.

Methods: A keyword search was done using the Science Direct, PubMed, and CINAHL databases. Inclusion criteria were that they must be original research, identify facilitators and barriers in interprofessional collaborative relationships, and include healthcare professionals involved in maternity care. The database search yielded a total of 348 articles, which were …

The Health Impact Of Clinical Training On Nursing Students In Cambodia, Felicia Kim Yee, Kimberly Aguilar Mondragon

Nursing | Senior Theses

Background: Clinical training presents significant challenges for nursing students worldwide, particularly evident in developing countries like Cambodia, where these difficulties are intensified by a lack of training, resources, and health issues like stress and fatigue. Many students struggle without adequate guidance, forcing them to navigate complex clinical environments independently. These factors not only impact students’ confidence and academic performance, but also their health and well-being. Through this study, we can gain insight into nursing in a developing country that hasn’t been widely studied, contributing to global nursing research. Purpose: The purpose of this study is to explore the health impact …

Psychological Impact Of Ulcerative Colitis On Pregnancy And Postpartum Period, Stephanie C. Carver

Nursing | Senior Theses

Background

Ulcerative colitis (UC) poses significant challenges during pregnancy, affecting both physical and mental health. While the physiological effects of UC during pregnancy are well documented, less is known about its impact on maternal mental health. This study aims to investigate the psychological effects of UC on pregnant women, focusing on stress levels, postpartum depression (PPD) incidence, and the role of multidisciplinary care in improving mental health outcomes.

Objective

The primary objective of this research proposal is to evaluate the psychological impact of UC during pregnancy and determine whether disease activity increases the risk of PPD and stress. A secondary …

Improving Maternal Mental Health: The Role Of Specialized Support For Queer Women With Postpartum Depression, Dan-Tam Pham

Nursing | Senior Theses

Queer women face disproportionately high rates of postpartum depression compared to heterosexual and cisgender individuals. Studies showed that queer women face heightened mental health challenges, including higher rates of depression and anxiety due to factors like discrimination, limited support systems, and negative healthcare experiences. There is a need for culturally competent, LGBTQ+-affirming interventions to improve maternal mental health outcomes; despite the health disparities faced by this population, research on specialized postpartum interventions is limited, revealing gaps in effective mental health care for queer mothers. The key search terms for the articles used in the study included: postpartum depression, queer women, …

The Integration Of Video Recording In Health Assessment Simulation To Improve Feedback Quality, Stephanie Bork, Meredith Deegan, Allison Gregory

School of Nursing Publications

Introduction

Simulation-based learning is integral in preparing nursing students, especially graduate-level nurse practitioner (NP) students. Simulation bridges the gap between theory and practice, providing a safe space for students to practice clinical skills, communication, and develop appropriate clinical judgment and reasoning before delivering care to patients in healthcare settings. Video recording in the simulated environment enhances educators’ ability to assess student competency and performance. During a faculty-observed simulation, it can be challenging to deliver consistent, meaningful, and competency-based feedback to each student. This project aims to integrate Echo360 video recording in graduate health assessment simulation to enhance the quality of …

The Ethical Justification Of Application Of Long-Acting Reversible Contraception In Patients With Intellectual Disabilities, Kelly Savitri

Journal of Health Ethics

This paper explores the ethical justification for the use of Long-Acting Reversible Contraception (LARC) in patients with intellectual disabilities, particularly in scenarios where patients cannot provide informed consent. The tension between respecting autonomy and ensuring beneficence presents a complex challenge for healthcare providers. Drawing on historical context, current reproductive justice issues, and evolving societal attitudes towards individuals with intellectual disabilities, this essay argues for a semi-discrete model that recognizes the need to prioritize patient health and safety while valuing their autonomy. By examining the implications of both past and present practices, this study highlights the necessity for healthcare providers to …