Digital Commons Network^™

Staff Education On Implementing Exercise For The Management Of Depression In Adults In A Comprehensive Mental Health Facility, Afolasade Jarrett

Walden Dissertations and Doctoral Studies

In a comprehensive mental health facility, patients diagnosed with major depression continue to experience depressive symptoms despite treatment. Despite using standard treatment with antidepressants and psychotherapy, facility data showed that 40% of these patients are still experiencing depression symptoms that negatively impact their overall functioning and quality of life. There is evidence supporting exercise as an effective strategy for depression treatment. Therefore, a staff education project was proposed to educate staff about exercise for depression management in adults. A thorough literature search in four databases yielded 12 articles with high quality evidence supporting educating staff to use exercise for depression …

Staff Education On Vital Sign Assessment And Electronic Health Record Documentation For Acute And Critical Care Nurses And Patient Care Technicians, Natalie Brock

Walden Dissertations and Doctoral Studies

A staff educational quality improvement initiative aimed at enhancing the knowledge and accuracy of acute care nurses and patient care technicians (PCTs) in vital sign documentation was the focus of the doctoral project. Gaps in vital sign obtainment and electronic health record (EHR) documentation were identified through organizational serious safety event reviews, highlighting risks to patient safety and clinical decision-making. The project addressed the question of whether, in the inpatient hospital setting, a staff educational training program for acute and critical care nurses improves their knowledge of accurate vital sign documentation in the EHR. I analyzed pre- and posttest assessments …

Education To Nursing Staff On Evidence-Based Lifestyle Interventions For Hypertension, Meagan Deese

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project that addressed a practice gap in a primary care setting related to limited nursing knowledge of evidence-based lifestyle interventions for hypertension management. Hypertension is a prevalent chronic condition and a major contributor to cardiovascular morbidity and mortality. Although clinical guidelines recommend lifestyle modification as first-line management, nurses may receive limited formal training in nonpharmacologic interventions. The practice-focused question was, in a primary care setting, does a nursing education program on evidence-based lifestyle interventions for hypertension improve nursing knowledge as measured pre- to post education? The purpose of the …

Skin Injury (Moisture-Associated Skin Damage, Skin Tears, And Pressure Injury) Prevention Education: An Evidence-Based Practice Project, Elizabeth Lopez

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Aims: Skin injuries, particularly pressure injuries, pose significant challenges in hospitals, especially for critically ill patients, leading to discomfort and increased healthcare costs. Such injuries profoundly impact patient outcomes, resulting in increased morbidity and mortality rates. Furthermore, these injuries can severely affect patients' quality of life, impeding their recovery. This project at LLUMC aims to address knowledge gaps among ED nursing staff regarding skin injury prevention through targeted education, thereby enhancing nurses' knowledge and confidence in managing these injuries.

Methodology: To evaluate the effectiveness of the skin injury prevention education initiative, eight tools were utilized, including the …

Effective Education Prevents Readmission Rates, Taylor Johnson, Gabby Belanger, Ben Mittleman, Bella Ferguson

Nurse Residency

PICOT Question: In older adult patients, does nurse-driven education, compared with standard care, reduce hospital readmission rates?

Missed Care Prevalence And Associated Factors In Acute Care Settings: A Systematic Review And Meta-Analysis, Afia Achiaa Sarpong, Lucy Gent, Amanda Towell-Barnard, Diana Arabiat

Research outputs 2022 to 2026

Aim: The aim of the study was to comprehensively analyse the prevalence and factors associated with missed nursing care in acute care settings. Methods: A systematic review was conducted to estimate the prevalence of missed nursing care, types of activities missed and associated factors in acute care hospital settings. Five electronic databases (CINAHL, Embase, Medline, PubMed and Scopus) were searched from inception to 14th December 2022. Type of missed care and associated factors were classified based on missed care concepts, definition and measurement. Random effects meta-analysis was performed to estimate proportions and levels of types of nursing activities missed. Results: …

International Normative Charts For Twin Weight, Length, And Head Circumference At Birth, By Gestational Age And Sex: The Twin Neonatal Cross-Sectional Study Of The Intergrowth-21st Project, Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A. Jaffer, Manorama Purwar, Fernando C. Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low …

Caring For Post Icu Patients: Knowledge And Attitude Among Nurses Working In General Wards, At Tertiary Hospitals, Dar Es Salaam, Tanzania, Nazahed Mkiramweni, Kahabi Isangula, Masunga Iseselo, Dickson Mkoka, Emmanuel Mlay

School of Nursing & Midwifery, East Africa

Introduction: Caring for patients from the Intensive Care Unit (post-ICU) in general wards iscritical in determining patient outcomes. As primary caregivers, nurses provide hour-to-hour care and are essential in monitoring and addressing any signs of deterioration during this crucial transition period. Adequate knowledge and a positive attitudeare vital for ensuring the timely identification and management of complications. This study aimed to assess the knowledge and attitudes of nurses caring for post-ICU patients in general wards.

Methods: A hospital-based descriptive cross-sectional study wasconducted from May to August 2021 at Muhimbili National Hospital (MHN), Muhimbili Orthopedic Institute (MOI), and Jakaya …

Meeting Nurses Where We're At, Michal Brown, Kayley Mclaughlin, Lauren Damm

Nurse Residency

PICOT Question: For night shift nurses, how does implementing flexible shift-friendly educational strategies, such as reordered or alternatively scheduled sessions, compare with traditional morning in person education classes affect their ability to positively participate and engage in required education throughout the nurse residency program?

Children's Experiences Of Functional Constipation: A Qualitative Reflexive Thematic Analysis, Gunilla Flankegård, Patrik Rytterström, Berit M. Gustafsson, Evalotte Mörelius

Research outputs 2022 to 2026

Background: Childhood functional constipation, a common concern within child healthcare, necessitates oral and rectal medical treatments, that are mostly administered by parents in the home environment. It is important to gather children's perspectives in child- and family-centred care. The private nature of toileting, bowel movements, and faecal incontinence are areas of taboo and stigmatisation. Research is scarce on how children perceive this common but private situation of oral and rectal constipation treatment. Objective: To explore children's experiences of functional constipation and its treatments. Design: A qualitative interview study with a constructionist epistemology and a predominantly experiential orientation. Setting: Individual interviews …

Contemporary Structures, Processes, And Outcomes Of Critical Care Nursing Education: An Integrative Review, Farida Saghafi, Carol Grech, Belinda Causby, Angelique Clarke, Jacqueline Jauncey-Cooke, Deb Massey, Kaye Rolls, Kylie Thompson, Melanie Greenwood

Research outputs 2022 to 2026

Objective: The critical care workforce requires nurses who are specialised, educated, and adaptable to manage complex situations, with the capability to make informed decisions for optimal patient care. The Australian College of Critical Care Nurses supports evidence-based practice through an education position statement, which is periodically updated to reflect evolving needs. In this review, our aim was to inform revisions to the position statement on critical care nurse education by examining the structure, processes, and outcomes of contemporary education programs designed to enhance the capability of registered nurses working in critical care environments internationally. Review method used: An integrative review …

Intrapartum Experiences Of Gestational Surrogates And Intended Parents In Australia: A Qualitative Study, Jutharat Attawet, Leo Ng, Evie Kendal, Yunjing Qiu, Myles Ojabo, Sarah Jefford, Micah D.J. Peters

Research outputs 2022 to 2026

Background Gestational surrogacy is an increasingly visible, though tightly regulated, pathway to parenthood in Australia, yet intrapartum care remains under-examined. Existing maternity models are grounded in woman-centred care and offer limited guidance for births involving surrogates and intended parents within a triadic care relationship. Objectives To describe the intrapartum experiences of gestational surrogates and intended parents in Australia and to identify care processes that support or hinder respectful, inclusive practice. Methods A descriptive qualitative study was conducted with purposive sampling. Seventeen participants took part between December 2024 and May 2025, comprising nine gestational surrogates and eight intended parents who had …

Making It Up As We Go: Midwives’ Perceptions Of Preparedness And Role Clarity In Surrogacy Birth Care, Jutharat Attawet, Leo Ng, Yunjing Qiu, Evie Kendal, Myles Ojabo, Sarah Jefford, Micah D.J. Peters

Research outputs 2022 to 2026

Background Surrogacy poses unique clinical, psychosocial, and organisational challenges. Midwives, often with limited experience, education, and guidance, may feel uncertain about providing appropriate care, potentially affecting the quality of care and experiences of surrogates, intended parents, and newborns. Objective This study explored how midwives navigate surrogacy birth care, with a focus on role clarity, involvement of intended parents, and preparedness across the intrapartum and postnatal continuum. Method An interpretative phenomenological design was adopted. Five midwives with experience in surrogacy births were recruited through professional networks and the Australian College of Midwives newsletter. In-depth interviews were conducted and analysed using reflexive …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Enhancing Rn Confidence In Early Recognition And Treatment Of Sepsis, Tiffany Lee Gossai

Walden Dissertations and Doctoral Studies

Background: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Staff Education To Improve Nurse Use Of Teach-Back In Outpatient Diabetes Care, Latoya Hodge-Curtis

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a prevalent chronic condition in the United States, with ineffective patient education and low health literacy linked to poor glycemic control, preventable complications, and increased health care utilization. At the project site, a practice gap was identified related to a lack of knowledge among nurses regarding the use of teach-back strategy for use with Type 2 diabetes education. The practice-focused question was: Does educating nurses on the teach back strategy for Type 2 diabetes improve knowledge as evidenced by pre- to post-survey? This project was implemented using the ADDIE (analysis, design, development, implementation, and evaluation) …

Enhancing Medication Adherence In Home-Based Hypertension Care Through Targeted Staff Education, Marie Lunie Bazile

Walden Dissertations and Doctoral Studies

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education …

Staff Education On Medication Adherence, Jerome Obiagba

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice …

Staff Education To Streamline Congestive Heart Failure Education, Shannon Hunter

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive disease that affects a diverse population. Patient-centered education is key to lowering rehospitalizations and mortality rates. Although nurses are essential providers of patient-centered education, those in acute care settings often have unclear directions for implementing and documenting CHF education. Multiple educational materials within electronic health record (EHR) systems further complicate the process and highlight the practice gap. The aim of this Doctor of Nursing Practice (DNP) project was to streamline CHF education by clarifying the role of nurses in education delivery and documentation, potentially enhancing nurse confidence and improving patient health outcomes, with …

Mental Health First Aid Training In K-12 Schools, Jenna L. Workman, Brianna L. Schierberg, Grace H. Sullivan, Erin Robinson

Posters-at-the-Capitol

The increasing prevalence of mental health challenges among school-aged children has become a rising public health concern. Recent data indicates that nearly 70% of schools report heightened mental health problems among students, with anxiety and depression being most common (National Center for Education Statistics, 2024). The purpose of this capstone project is to raise awareness of mental health issues in K–12 public schools and to increase faculty and staff confidence in recognizing and assisting students experiencing mental health difficulties through nurse-led Mental Health First Aid (MHFA) training. Using Peplau’s Interpersonal Relations Theory as a guiding framework, this project emphasizes the …

Executive Leadership System Improvement Mobile Lung Cancer Screening, Tracy Holladay

Walden Dissertations and Doctoral Studies

This doctoral project is an evidence‑based practice initiative to develop a mobile lung cancer screening program that expands early detection services in rural Arkansas. The practice problem involves low screening rates, high mortality, and access barriers that delay diagnosis for high‑risk individuals, making this work essential to nursing roles in prevention, coordination, education, and population health. The practice focused question examined whether creating a Mobile Lung Cancer Screening Unit proposal will support timely referrals and treatment. The purpose of the project was to design a feasible, evidence informed model aligned with organizational capacity and equitable access goals. Analytical strategies included …

Staff Education To Emergency Nurses On Improving Handoff Communication Using The I-Pass Tool, Lekeyna Gleason

Walden Dissertations and Doctoral Studies

Effective communication during nurse-to-nurse handoff remains a critical determinant of patient safety in high-acuity emergency settings, where rapid decisions and fluctuating clinical demands can lead to inconsistent structure, omission of critical information, and inefficient transitions of care. The practice gap identified was a lack of standardized knowledge and consistent use of a structured bedside handoff tool among emergency department (ED) nurses. The practice-focused question guiding this project was, Does educating ED nurses on using the I-PASS bedside handoff tool improve knowledge of structured bedside reporting as measured by pre- and post-implementation surveys? The ADDIE framework and the Johns Hopkins evidence-based …

Staff Education For The Management Of Chronic Pain In Patients With Mental Health Disorders, Jude Osagie Ukpebor

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a practice-focused quality improvement staff education initiative designed to address a gap in nurses’ knowledge related to chronic pain management in patients with mental health disorders. Chronic pain frequently coexists with psychiatric conditions, yet nurses often lack formal education on biopsychosocial, trauma-informed, and non-pharmacologic pain management approaches, contributing to fragmented and inequitable care. Addressing this gap is essential to improving patient outcomes and advancing evidence-based nursing practice. The practice-focused question asked whether implementing a targeted nurse education program would improve nurses’ knowledge related to chronic pain management in patients with mental health disorders. …

Staff Education To Enhance Psychiatric Medication Adherence In Psychiatric Care, Emmanuel Nusta

Walden Dissertations and Doctoral Studies

Medication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play …

Staff Education On Metabolic Syndrome Screening In Patients Receiving Long-Acting Injectable Psychotropics, Efetze Metangpa Akana

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was a staff education initiative designed to improve metabolic syndrome screening practices for patients receiving long-acting injectable psychotropic medications in an outpatient psychiatric setting. People living with serious mental illness face a heightened risk of cardiometabolic conditions, and inconsistent screening leads to delayed detection, avoidable illness, and ongoing health disparities, underscoring the importance of this practice gap within nursing practice due to nurses’ central role in medication oversight and preventive care. A key limitation of the project was the small sample size and short-term evaluation period, which limited generalizability and did not allow …

Self-Stigma Of Seeking Help, Psychological Safety, And Employee Assistance Program Use In Nurses, Latisha Lenee Marshall

Walden Dissertations and Doctoral Studies

Employee assistance programs (EAPs) remain underutilized across various U.S. work sectors, including nursing. There are several barriers that impede nurses from using EAP services, including self-stigma of seeking help (SSOSH) and psychological safety (PS). The purposes of this study, which used the health promotion model as its theoretical framework, were to determine (a) if there was a difference in the level of SSOSH in nurses who have used EAPs and those who have not used EAPs, (b) if there was a difference in the level of PS in nurses who have used EAPs and nurses who have not used EAPs, …

Implementation Of Structured Nursing Leadership Rounding To Improve Hospital Policy Adherence, Irma Rose Maize

Walden Dissertations and Doctoral Studies

Variability in nursing policy compliance contributes to inconsistent clinical practice and compromises the delivery of standardized care. Limited leadership presence, support, and accountability have been identified as significant contributors to this practice gap. This Doctor of Nursing Practice project focused on educating nurse leaders about the importance and benefits of consistent unit-based leadership rounding as a strategy to support frontline nurses and reinforce policy adherence. A structured leadership rounding checklist was developed to guide purposeful, consistent check-ins with nursing staff, facilitating real-time support and identification of barriers to practice. Implementation of the checklist promoted increased leadership accessibility, improved communication, and …

Exploring The Relationship Among Nurse-Specific Factors And Triage Accuracy In The Emergency Setting, Krisada Suamchaiyaphum

ETDs from 2020-2029

Triage is a critical function of emergency nursing practice, directly influencing patient safety, flow, and outcomes in the emergency department (ED). Despite widespread use of standardized triage training and resources, triage accuracy among ED nurses remains suboptimal. The purpose of this three-manuscript dissertation was to examine factors associated with triage accuracy in the ED setting. Manuscript One was an integrative literature review of 14 studies published between 2011 and 2021, with reported triage accuracy rates ranging from 59.3% to 82%. Primary factors associated with triage accuracy were: nurse-specific, patient, and work environment factors. Manuscript Two reported a retrospective study of …

Staff Education To Increase Knowledge And Awareness Of Cultural Sensitivity Among Providers, Stephanie Chiamaka Anyanwu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project aimed to enhance cultural sensitivity among healthcare providers through an educational intervention in a local organization. With the U.S. foreign-born population exceeding 47 million, the need for culturally competent care has become paramount. The study involved nine participants who underwent a pretest and posttest assessment to evaluate their knowledge and awareness of cultural sensitivity. Results indicated a significant increase in knowledge, with pretest and posttest scores improving from a mean of 4.33 to 8.56 (p < 0.01). Awareness in key areas such as patient-provider relationships, cultural beliefs, and language barriers also showed marked improvement. These findings further support the necessity of ongoing cultural sensitivity training to enhance patient care and outcomes, highlighting the potential for broader application across healthcare institutions.