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Reducing Stigma And Enhancing Outcomes: An Antistigma Education Program For Mental Healthcare Professionals, Chidi Oriaku

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project that addressed the stigmatization of patients with mental illness (PMI) within psychiatric contexts. The project site healthcare organization’s mental health professionals had a high rate of stigmatization of PMI. Stigma is linked to poor medication adherence rates, delays in accessing healthcare, lower healthcare utilization among PMI, psychiatric morbidity and mortality, and poor quality of life. Despite recognizing this problem, the healthcare organization had no targeted antistigma interventions. I developed an antistigma education to improve outcomes. The practice-focused question was: In mental health staff, will an educational program on …

Staff Education To Improve Knowledge On Facilitation Of Psychoeducational Groups, Kenyett Moody

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Kenyett Moody 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. Margaret Harvey, Committee Chairperson, Nursing Faculty Dr. Robert McWhirt, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Background and Purpose: Nurse-led psychoeducation groups are essential for improving patient outcomes by educating individuals about health conditions and coping strategies. In a dual-diagnosed inpatient psychiatric unit, a quality improvement (QI) project …

Staff Education To Increase Knowledge About The Workflow Process, Mwikali Mutia-Lamin

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was conducted to address staff’s lack of knowledge about the workflow process in an outpatient mental health setting. Evidence has shown that staff’s lack of knowledge about workflow processes creates ineffective communication and collaboration in care as well as reduces patient outreach. The practice-focused question was focused on determining whether training staff in an outpatient mental health setting about the organization’s workflow process increased their knowledge on how to use the workflow process in an effort to improve patient care and care outcomes. Thirteen of the 20 staff members participated in this educational …

Staff Education To Pediatric Healthcare Providers On How To Prevent Unintentional Childhood Injuries., Peter Cleveland Collins

Walden Dissertations and Doctoral Studies

This staff education quality improvement Doctor of Nursing Practice (DNP) project was focused on teaching pediatric healthcare providers how to provide education during wellness visits to prevent unintentional childhood injury. The practice problem at the clinic was that pediatric providers lacked knowledge about injury prevention. A literature review showed that unintentional childhood injuries are the leading cause of death in this population. The practice-focused question determined was to determine if, after educating providers, they have improved knowledge and intent to educate their patients. I used the analysis, design, development, implementation and evaluation (ADDIE) model to guide this project. The participants …

Staff Education On Mindfulness-Based Therapy To Address Compassion Fatigue, Samson Ajibola Omowumi

Walden Dissertations and Doctoral Studies

The nature of nursing practice—persistent exposure to patient suffering—often results in compassion fatigue for staff. Compassion/emotional fatigue can affect nurses’ mental well-being, which can manifest in burnout, decreased empathy, and emotional numbness. These outcomes can eventually reduce job satisfaction for nurses and nursing assistants, increase errors during patient care, and lead to poorer patient outcomes. Prioritizing caregivers' mental health may improve the quality of nursing care. Mindfulness-based therapy (MBT) is an approach that may ensure the mental health and emotional stability of those who care for patients while also being a comparatively easy, accessible, and affordable tool. The goal of …

Evaluating The Active Learning Experience Of Prelicensure Nursing Students By Role And Level In Simulation, Delisa Flynn

Dissertations

As the complexity of healthcare continues to grow, it is essential that nursing graduates enter the workforce with strong clinical judgment, confidence, and practice readiness. Simulation is an active learning strategy that creates a realistic, hands-on experiences for learners. Despite its widespread use, the impact of simulation roles within a simulated experience (participant versus observer) on student engagement remains unclear, particularly across different levels of nursing education. This study investigated differences in active learning engagement among sophomore and senior prelicensure nursing students (N = 161) based on their assigned role in a high-fidelity simulation scenario. Grounded in Kolb’s Experiential Learning …

Resilience, Elapsed Time Since Exposure To Workplace Violence, And Job Satisfaction Among Emergency Nurses In The United States, Ginny Glisson Ennis

Walden Dissertations and Doctoral Studies

The emergency nursing profession faces a critical challenge with a declining workforce and a high prevalence of workplace violence (WPV), which negatively impacts nurse job satisfaction. This quantitative study examined the relationships among nursing resilience, time elapsed since WPV exposure, and job satisfaction among emergency nurses (ENs) in the United States. Grounded in resilience and Herzberg’s two-factor theories, this study used a cross-sectional, correlational design. A national, anonymous online survey was distributed via social media, using a sharable QR code to recruit participants. The survey consisted of a total of 52 items, and collected demographic data, and time elapsed since …

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

Quality Improvement Project The Role Of Targeted Education And Its Impact On Self-Efficacy And Cognitive Impairment Recognition Among Medical Assistants, Jicky Guzman

Doctor of Nursing Practice Projects

Primary care teams develop lasting relationships with patients that can reveal subtle cognitive changes during routine visits (e.g., identity verification and brief mobility checks). Yet, cognitive decline often goes unnoticed and poorly documented, which can lead to delayed care. This quality improvement (QI) project addressed a gap in the detection of mild cognitive impairment (MCI), such as Alzheimer’s disease (AD), among frontline staff. It assessed whether an educational intervention could improve self-efficacy in recognizing early cognitive impairment, measured by the General Self-Efficacy Scale (GSES). Guided by Bandura’s Self-Efficacy Theory and Lewin’s change model, a quasi-experimental pretest–posttest study was conducted at …

Medication Adherence: A Reimbursable Theory-Guided Evidence-Based Educational Intervention For Patients With Parkinson’S Disease, Amanda E. George, Melinda Hermanns, Diane B. Monsivais, Cheryl D. Parker

Nursing Faculty Publications and Presentations

Background: Parkinson’s disease is a challenging, progressive neurodegenerative process projected to affect more than 1.2 million patients by 2030, with an economic burden that will surpass $79 billion annually in the United States. Pharmacological interventions are the hallmark of treatment for symptom management for this lifelong disease. Multiple medications and a variety of dosing times have an increasingly negative effect on medication adherence. Purpose: This article will discuss medication adherence challenges, describe a theory-guided evidence-based intervention to improve medication adherence, and explore the economic implications in an outpatient clinic setting. Methods: A pilot chart review of 40 cases over 30 …

The Relationships Between Sporadic And Repetitive Non-Suicidal Self-Injury And Mental Disorders Among First-Year College Students: Results From The World Mental Health International College Student Initiative, Penelope Hasking, Glenn Kiekens, Maria Petukhova, Yesica Albor, Ahmad Al-Hadi, Jordi Alonso, Nouf Al-Saud, Yasmin Altwaijri, Claes Andersson, Lukoye Atwoli

Brain and Mind Institute

Background: Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults.

Methods: We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in …

Mindfulness-Based Interventions For Adults With Coronary Artery Disease: An Integrative Review Of Impact On Risk Factors And Outcomes, Alexa Archer, Kristiina Hyrkas

MaineHealth Maine Medical Center

Aim: To synthesize recent evidence on the effects of MBIs on psychological and cardiovascular health.

Nurses’ Knowledge About Assisted Reproductive Methods And Their Awareness About It In Potential Immune-Related Outcomes Of Conceived Children, Salma Abd-Elatty Moawed, Abdallah Ahmed Said

Nursing

Abstract A rising worldwide health concern, infertility is impacted by a number of environmental and lifestyle factors. With cutting-edge methods like intrauterine insemination, intracytoplasmic sperm injection, and in vitro fertilization, assisted reproductive technology gives infertile couples hope. Because they provide clinical care, education, and emotional support before, during, and after assisted reproductive technology procedures, nurses are essential to its success. The purpose of this study is to assess nurses’ knowledge and awareness about assisted reproductive methods and the immune outcomes among the resulting children. A structured interview questionnaire will be used to gather data from 130 nurses as part of …

Behavior Change Communication Strategies On Human Immunodeficiency Virus /Acquired Immunodeficiency Syndrome Risk Reduction For Long-Distance Truckers In Kenya, Cyrus Mutie, John Gachohi, Kawira Kithuci, Grace Mbuthia

School of Nursing & Midwifery, East Africa

Background Long-distance truckers (LDTs) not only experience heightened risk of human immunodeficiency virus (HIV) infections due to risky sexual networks, but are also hard to reach with consistent risk reduction messages due to their often disruptive work schedules. Besides, evidence of the existing behavior change communication (BCC) strategies to enhance HIV/ acquired immunodeficiency syndrome (AIDS) risk reduction is limited. Thus, the study sought to explore the most effective and preferred BCC strategies for adoption among LDTs in Kenya.

Methods and Methodology Nine key informants and 18 in-depth interviews were used to gather qualitative data from purposively sampled participants at Kenya's …

Examining Nurses’ Perspectives Of Organizational Strategies Designed To Enhance Job Satisfaction, Kerine J. Moodie-Brown

Walden Dissertations and Doctoral Studies

Nurse job satisfaction remains a critical issue in healthcare, as it directly impacts patient care quality, nurse retention, and organizational performance. Despite numerous organizational efforts, there is limited qualitative insight into how nurses perceive strategies aimed at improving their satisfaction. The purpose of my study, guided by Maslow’s hierarchy of needs theory, was to explore nurses’ perceptions of organizational strategies designed to enhance job satisfaction, with a particular focus on interventions such as pay incentives, workplace safety, career development opportunities, nurse residency programs, and initiatives promoting well-being. Semi-structured interviews were conducted with 10 RNs having at least 1 year of …

Differences In Peer Social Connections Between Traditional And Online Nurse Residency Programs, Tatum Leonard

Electronic Theses and Dissertations

The anticipated retirement of baby boomer nurses by 2030 will intensify the global nursing shortage, a crisis that demands innovative strategies for onboarding and retaining new graduate nurses. Nurse residency programs (NRPs) are designed to ease the transition from student to practicing nurse, reduce turnover, and foster professional resilience. Amid the COVID-19 pandemic, many NRPs rapidly transitioned from traditional, in-person seminars to synchronous, online formats. This study explored differences in peer social connections between traditional and online NRPs, focusing on three constructs: sense of community, collaborative learning, and peer social support. Using a quasi-experimental, mixed methods approach, this secondary data …

Experiences And Perspectives Of Sexual And Reproductive Health Among Women In Recovery From Opioid Use Disorder, Nicole M. Mattson, Aleigha Barry, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

Background

Women in recovery from opioid use disorder (OUD) have unmet sexual and reproductive health (SRH) needs resulting in health disparities such as unintended pregnancy and sexually transmitted infections/HIV infection compared with women without OUD. The purpose of this qualitative descriptive study was to explore the perceptions and experiences of co-occurring multiple social-ecologic influences (individual, interpersonal, community, society) on SRH among women in recovery from OUD.

Methods

Purposive sampling was used to recruit cis-gender women aged 18–49 who self-identify as being in recovery from OUD and speak English. We conducted one 45- to 60-minute audio-recorded semistructured telephone interview with each …

Multiyear Implementation And Qualitative Evaluation Of A Peer Mentoring Circle Program, Tana M. Karenke, Juanita T. Garcia, Alexandria Zielinski

College of Nursing Faculty Research and Publications

Background

Students from disadvantaged backgrounds often experience intensified challenges, including life stressors, social isolation, discomfort relating to the dominant culture on campus, and under-preparation if coming from low-resource high schools and neighborhoods. Multiyear implementation and outcomes of an ongoing peer mentoring circle (PMC) program for undergraduate nursing students from disadvantaged and underrepresented minority backgrounds are described.

Method

This study examined a 5-year longitudinal descriptive evaluation of ongoing PMC programming using thematic analysis.

Results

Four major themes were identified from student qualitative evaluation data: (a) connection and friendship; (b) adjustment and transition; (c) academic support; and (d) leadership skills. Challenges encountered …

Raising Provider Awareness Of Fluid Status In Women Undergoing Elective Cesarean Section Through The Use Of A Preoperative Checklist To Assess Fluid Status: A Quality Improvement Project, Marcus Miller, Michael Sorge

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract

Maternal hypotension following neuraxial anesthesia during cesarean section is a common and potentially harmful complication. While vasopressors are often used for this issue, they carry risks to fetal well-being. Goal-directed fluid therapy (GDFT) provides an individualized approach that may improve outcomes by optimizing fluid status perioperatively. This quality improvement project aimed to increase provider awareness of fluid status through the implementation of a preoperative checklist that assessed fluid status in women undergoing cesarean section. A preoperative fluid assessment checklist was developed using evidence-based predictors of fluid status and integrated into anesthesia workflow. The project followed the Plan-Do-Study-Act cycle and …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …

Quality Improvement Initiative For Emergency Cesarean Delivery: Implementation Of Rapid Sequence Spinal Anesthesia, Hunter L. Baselj, Joseph A. Gabster

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract

Background: General anesthesia (GA) for emergency cesarean sections (EmCS) poses potential risks Rapid Sequence Spinal Anesthesia (RSSA) offers a promising alternative that preserves benefits of neuraxial anesthesia while accommodating the urgency of EmCS. This quality improvement (QI) project aimed to implement and evaluate the use of RSSA at a teaching hospital, utilizing a decision-tree tool to enhance clinical efficiency and assess provider perceptions regarding its impact on airway complications and post-operative pain outcomes. Methods: A RSSA decision-making chart was developed and introduced to anesthesia providers at a teaching hospital. A total of 16 providers, including CRNAs, SRNAs, and anesthesiologists, …

Psychometric Properties Of The Turkish Version Of The Palliative Care Attitude Scale (T-Pcas-9) In Cancer Patients, Sevgi Demir Çam, Neşe İşcan Ayyildiz, Hasan Evcimen, Timüçin Çil, Berna Bozkurt Duman

Makara Journal of Health Research

Background: A reliable, validated Turkish measurement tool will allow researchers to measure the impact of attitudes towards palliative care on other health outcomes in individuals with chronic and critical illness. This study aimed to examine the Turkish psychometric properties of the Palliative Care Attitude Scale (PCAS-9) for individuals with cancer.

Methods: The Turkish adaptation of the PCAS-9 (T-PCAS-9) included 505 cancer patients, who were aged >18 years, had a diagnosis of cancer, and no mental problems. The factor structure of the T-PCAS-9 was examined using exploratory factor analysis, confirmatory factor analysis, convergent-divergent validity, and measurement invariance analysis.

Results: The three-factor …

Staff Education To Reduce Alarm Fatigue And Enhance Patient Safety Through Nurse Education On Telemetry Optimization, Casey Alan Metcalf

Walden Dissertations and Doctoral Studies

Summary This project was an evidence-based staff education initiative to reduce alarm fatigue and enhance patient safety through telemetry optimization in an acute care setting. The core issue involved the overuse of continuous cardiac monitoring, which contributed to nonactionable alarms, alarm fatigue, workflow inefficiencies, delayed throughput, and increased costs. The project was a structured intervention delivered to 171 telemetry nurses across three inpatient units. Pretests and posttests measured changes in knowledge, intent, and practice. Results showed a 22.9% increase in knowledge, a 92% agreement regarding intention to follow discontinuation protocols, and a 10% overall reduction in practice of telemetry use …

Staff Education On The Abbreviated Teachers’ Rating Scale (Atrs) Tool As A Screening Tool For Attention Deficit Hyperactivity Disorder (Adhd)., Tena E. Currie

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education program to enhance the treatment and diagnosis of attention-deficit hyperactivity disorder (ADHD) at a mental healthcare facility. The identified practice problem was the lack of knowledge about the Abbreviated Teacher Rating Scale (ATRS) used in ADHD testing, which may result in inaccuracies and underutilization of the tool. To bridge this gap is essential in nursing practice as clinicians should be competent in performing standard assessment, which is indispensable for patient with ADHD. Staff education with the ATRS was the practice-directed question for the project: Does staff education with the ATRS increase knowledge for …

Experiences Of First-Generation Nursing Students After Their First Year At An Hbcu: A Transcendental Phenomenological Study, Ari L. Cuffee

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore the lived experiences of first-generation nursing students (FGNS) after their first year at a Historically Black College or University (HBCU). The central research question asked, “What are the lived experiences of first-generation nursing students who have completed one year at a Historically Black University?” The theoretical framework that guided this study was Banks’ theory of multicultural education. This theory demonstrated how educators taught FGNS using the multicultural education paradigm with strategies and procedures to make provisions for culturally, racially, and ethnically diverse students. Data were analyzed using Moustakas’ interpretive phenomenological …

Increasing Patient Satisfaction And Engagement By Improving Patient Intake Process In An Outpatient Mental Health Clinic, Hotenesia Njoroge

Doctoral Dissertations and Projects

This scholarly project aimed to enhance patient satisfaction and engagement by improving the intake process in an outpatient mental health clinic. Inefficient intake procedures, characterized by long wait times, communication gaps, and misreferrals, contribute to patient disengagement and dissatisfaction. A quasi-experimental pretest-posttest design evaluated a patient-centered intervention involving communication training, streamlined workflows, and real-time updates. Data were collected from 52 participants using Patient-Reported Experience Measures (PREMs) and qualitative feedback. Quantitative results revealed high satisfaction with staff respect (M = 4.19), communication clarity (M = 4.06), and facility comfort (M = 4.13). Wait time satisfaction scored slightly lower (M = 3.96), …

Self-Efficacy And Burnout Of Nursing Faculty: The Mediating Role Of Fear Of Negative Evaluation, Sarah Murray Kelly

Doctoral Dissertations and Projects

The contents of this manuscript include a dissertation of a survey research study using the theoretical models of self-efficacy and burnout. The quantitative study used mediation analysis to explore the relationship between self-efficacy and burnout, with fear of negative evaluation as a mediator. Fear of negative evaluation was measured using the Brief Fear of Negative Evaluation Scale-Revised; self-efficacy was calculated using the General Self-Efficacy Scale; and burnout was measured using the Oldenburg Burnout Inventory. The study drew a sample of 98 academic nurse educators (N = 98) who were evaluated by student evaluations of teaching. The sample included educators who …

Enhancing Parental Knowledge Of Functional Medicine Interventions For Adhd: An Educational Initiative To Improve Caregiver Competency, Julie Gammer

Doctoral Dissertations and Projects

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent pediatric psychiatric condition often managed with stimulant medications that carry potential side effects and may not address underlying causes. Research findings indicate a significant gap in caregiver knowledge and confidence in treating their child's ADHD with functional medicine strategies. This project develops an evidence-based educational initiative designed to enhance caregiver knowledge and confidence in applying functional medicine interventions—such as dietary modifications, targeted supplementation, and gut health restoration—as natural, root-cause approaches to managing ADHD symptoms. The project utilized a 30-minute audiovisual presentation and was evaluated using pre- and post-intervention competency tests, as well as a …

Staff Education On Perinatal Opioid Use Disorder, Mukisha Livingston Gunter

Walden Dissertations and Doctoral Studies

Perinatal Opioid Use Disorder (POUD) constitutes a significant public health issue with important ramifications for both mothers and their newborns. The gap in practice identified for this Doctor of Nursing Practice staff education project was the perinatal nurses’ lack of knowledge regarding POUD. The problem was the need for POUD education for the nurses. The practice focus questions were: Will there be a change in knowledge by perinatal nurses following the delivery of the education as shown by a pretest/posttest? Will the participants evaluate the education as having met the program objectives related to the curriculum presented? Guided by the …