Digital Commons Network^™

What Matters To Residential Long-Term Care Residents: Contextualizing Perceptions Of Person-Centered Care, Luis J. Cordero, Sarah Dys, Diana White

Institute on Aging Publications

This study combines the CRITIC and DEMATEL methods and introduces a new hybrid scenario analysis approach that identifies cross-scenario strategies. We use Taiwan's wind energy industry as a case study to validate the process. Although scenario analysis has been applied across various fields and organization types—including strategic planning, education, training, and recent environmental issues—scholars have highlighted problems such as the subjectivity of qualitative analysis and the lack of quantitative evidence. To address this, this study integrates scenario analysis with quantitative multi-criteria decision analysis to support decision makers in conducting scenario evaluations. We achieve this by applying a multi-criteria approach to …

Polypharmacy In The Geriatric Population, Colleen Laflamme

Walden Dissertations and Doctoral Studies

The project entailed the development and review of a clinical practice guideline (CPG) for reducing polypharmacy in the geriatric patient population. Polypharmacy is associated with increased risk of adverse drug events (ADEs) such as drug-drug interactions, poor adherence to pharmacotherapy, and increased risk of falls. Additionally, polypharmacy tends to increase high hospitalization rates and emergency department (ED) visits. From a nursing practice perspective, polypharmacy worsens patient outcomes and increases nurses’ workload and healthcare costs for patients. The purpose of this project was to develop a CPG with evidence based recommendations on how to reduce polypharmacy among older adults. The practice-focused …

Teaching Staff About Pressure Ulcers, Ann Maria Stewart

Walden Dissertations and Doctoral Studies

Pressure ulcers are local injuries to the skin and underlying tissue primarily caused by prolonged pressure, friction, or shear forces. These preventable complications are prevalent among immobile patients and can lead to poor patient outcomes and increased healthcare costs. Despite the availability of evidence-based prevention strategies, significant gaps in practice continue due to limited staff knowledge, ineffective communication systems, and inconsistent implementation of established guidelines. This Doctor of Nursing Practice (DNP) project focused on enhancing nursing staff knowledge through an evidence-based educational strategy designed to educate staff on strategies for preventing pressure ulcers. The education program included a PowerPoint presentation …

Staff Education To Address Workplace Violence Against Staff, Julie Ann Childers

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) project, the primary focus was on addressing knowledge of workplace bullying within the hospital setting. The project involved developing and implementing an educational program to raise awareness, prevent workplace bullying, and effectively respond to it among healthcare staff. Workplace bullying harms physical and emotional well-being, reduces productivity, increases absenteeism, and increases turnover. The practice-focused question was as follows: In a hospital setting, does implementing a workplace violence (WPV) prevention education program for healthcare workers lead to increased knowledge of WPV incidents, awareness, and management among staff? Using evidence-based strategies and resources, the DNP …

Need For A Psychiatric Facility To Develop A Clinical Practice Guideline On Self-Care To Give To Patients Upon Discharge, Judith Agwu

Walden Dissertations and Doctoral Studies

The project is a Doctor of Nursing Practice (DNP) clinical practice guideline (CPG) on the need for a psychiatric facility to develop a CPG on self-care to give to patients upon discharge. The practice problem was a healthcare facility did not have guidelines to educate patients on self-care upon discharge. Addressing the problem within nursing practice can promote self-care practices and improve overall health outcomes for patients with mental illnesses. The practice-focused question that guided this project was: will a CPG potentially increase self-care among discharged patients? The purpose of the study was to develop a CPG on self-care for …

Faculty Perceptions Of Student Use Of Critical Thinking And Clinical Judgment In Prelicensure Alternative Pediatric Clinical Education, Vanessa Lee Lugo

Walden Dissertations and Doctoral Studies

Both the changing healthcare environment and diverse pediatric care needs highlight the importance of exploring nontraditional clinical placements for entry-level pediatric nursing students to assess their critical thinking (CT) and clinical judgment (CJ). Many graduates are unprepared for pediatric care, creating safety risks and gaps in meeting children’s healthcare needs. The purpose of this study, guided by communities of practice theory, was to explore faculty experiences with and perceptions of CT and CJ use at alternative pediatric clinical sites for prelicensure undergraduate students in the Northeastern United States. Eleven nursing faculty with recent experience working in nontraditional pediatric sites and …

The Effects Of A Nurse-Led Peace Program On Perceived Peaceful End-Of-Life And Quality Of Life Among Head And Neck Cancer Patients Undergoing Concurrent Chemoradiation, Sirinya Pimvichai, Yaowarat Matchim, Tanadej Sinthusake, Kiratiya Wongkalasin

Journal of Health Research

Background: Evidence indicates that peaceful end-of-life care programs benefit terminally ill patients, with nurses playing a central role in program delivery. However, no structured end-of-life care programs currently exist for patients with head and neck cancer (HNC), who often experience profound physical and psychological distress. A nurse-led Peaceful End-of-Life Care (PEACE) program was therefore developed. This study aimed to evaluate the effects of the PEACE program on perceived peaceful end-of-life (PEOL) and quality of life (QoL) among HNC patients undergoing concurrent chemoradiotherapy (CCRT).

Methods: A quasi-experimental, two-group time-series design was conducted with 64 HNC patients recruited from oncology wards at …

Improving Alcoholism Treatment Through Adverse Childhood Events Score Education, Miranda Cobenais

Walden Dissertations and Doctoral Studies

Summary I conducted this Doctor of Nursing Practice (DNP) staff education project to improve knowledge and clinical practice among mental health professionals. The problem identified at the project site was the limited awareness and use of Adverse Childhood Events (ACE) assessments in treating alcoholism. The practice focused question for this project was: Will educating staff on how ACE scores can improve treatment of alcoholism increase staff knowledge regarding the importance of assessing ACE scores to decrease relapse rates? The purpose of this doctoral project was to evaluate if an educational intervention can enhance staff understanding of the connection between ACEs …

“It Seems Like A Never-Ending Job”: Voices Of Female Caregivers Of Older Adults In The Rural Communities, Lalani Nasreen, Bhagyashree Katare, Evans Appiah Osei, Siqi Yang, Sampada Wagle, Julian L. Gallegos, Abidemi Mary Ajuwon

School of Nursing Faculty Publications

Background: Rural female caregivers of older adults face significant caregiving challenges that puts them at high risk for poor self-care and wellbeing. Limited studies have examined the self-care needs of caregivers from a gender equity and social perspective.

Objective: Our study aims to explore the self-care needs and preferences of rural female caregivers and underlying key processes contributing toward their health and well-being. Methods: A qualitative descriptive design was used for the study. A purposive sample of (n = 20) rural female caregivers was obtained. In-depth individual interviews were conducted for data collection. Each interview was about 45- 60 min …

Falls Prevention In A Psychiatric Setting, Albert Koroma

Walden Dissertations and Doctoral Studies

The project is a staff education initiative designed to improve the knowledge of psychiatric mental health clinicians regarding fall prevention. The gap in practice was the staff’s knowledge deficit in fall prevention. The staff’s knowledge deficits result in inconsistent prevention strategies. The practice-focused question guiding the project was: Among psychiatric mental health clinicians, does participation in an evidence-based fall prevention education program increase knowledge of fall prevention strategies as compared to pre- to post-education? The purpose of the project was to improve clinician knowledge of psychiatric-specific fall risks and evidence-based prevention strategies. The analytical strategies utilized in the project included …

The Relationship Between The Health Science Reasoning Test And Successful Completion Of An Associate Degree Nursing Program: A Retrospective Predictive Study, Joyce A.Ajkuce Kucerovy

Doctoral Dissertations and Projects

The purpose of this study was to retrospectively identify whether the addition of an entrance exam such as the Health Science Reasoning Test (HSRT) to the current admission criteria of an associate degree nursing (ADN) education program would aid in selecting students with the highest chance of successfully completing the program and entering the workforce. A nonexperimental, retrospective, quantitative, predictive correlational study design was used. A retrospective convenience sample of 320 first-year nursing students in an ADN education program was obtained. The G* power analysis showed a minimum sample size of 107 students was needed. Statistical analysis involved a multiple …

Treatment For Women With Mental Health Disorders Associated With Reproductive Health: An Opportunity For Interprofessional Collaboration, Ellen Modlin Phd, Otr/L, Bcp, Caps, Deana Goldin Phd, Dnp, Arnp, Fnp-Bc, Pmhnp-Bc

Journal of Interprofessional Practice and Collaboration

Abstract

Purpose: This article proposes an opportunity for interprofessional collaboration between mental health practitioners (MHPs) and occupational therapy practitioners (OTPs) for the treatment of women experiencing mental health disorders (MHDs) associated with reproductive health (RH) changes throughout the lifespan. This collaborative approach have the potential to optimize women’s health care and mitigate the risk of fragmented care, as these conditions are highly complex.

Method: Peer- reviewed literature from mental health and occupational therapy (OT) research was reviewed and summarized. The search focused on the barriers and potential opportunities for collaboration between MHPs and OTPs in women affected with MHDs associated …

Development Of An Educational Intervention To Enhance Nurses’ Knowledge And Intent To Implement Evidence-Based Diabetes Self-Management In Clinical Practice, Anne Marie Sieyou Ngouane

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was purposed with closing critical gaps in staff knowledge and adherence to diabetes self-management protocols in a busy primary care clinic. Rising readmission rates and uneven use of American Diabetes Association (ADA) standards signaled an urgent need for a structured approach to staff education. To address this, a one-hour interactive training session was created that blended teaching, evidence-based handouts, and a practical diabetes care checklist. Staff learning was measured through pretest and posttest, confidence and adherence used a 5-point Likert-scale survey, and 21day readmission data tracked patient outcomes. The project question asked if …

Enhancing Anxiety Identification In Adult Patients, Wonda Crump

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing (DNP) project, I focused on implementing a staff education program for anxiety screening at a health and wellness clinic. Mental health conditions, particularly anxiety disorders, are common in primary care settings. Research shows that anxiety affects millions of adults, yet many cases remain undiagnosed. The practice problem that I identified was that many patients with anxiety disorders were going undiagnosed during regular clinic visits. The clinic had no standard process for screening anxiety, and staff members had a knowledge deficit on the proper use of anxiety assessment tools. This gap in practice led to missed …

Staff Education To Enhance Provider Knowledge On Lifestyle Modification For Hypertension Management, Chinyere Maria Assumpta Ofoegbu

Walden Dissertations and Doctoral Studies

Summary A doctor of nursing practice (DNP) staff education project was designed to enhance healthcare providers' knowledge of lifestyle interventions for hypertension management. At the practice site, primary healthcare providers were not regularly integrating lifestyle counseling. The practice-focused question guiding this project was: In primary care providers, how does implementing an evidence-based lifestyle education training program for hypertension management affect provider knowledge? An in-person educational session was provided to ten (10) healthcare practitioners who voluntarily participated. Pre- and post-training knowledge assessments was the analytical techniques employed to examine changes in provider comprehension of lifestyle-based hypertension care. Descriptive statistics and paired-sample …

Multidisciplinary Approach To Reducing Healthcare-Associated Infections: A Dnp Project, Jovinsky Jonaldo Eliscard

Walden Dissertations and Doctoral Studies

Healthcare-associated infections are increasingly common in healthcare facilities due to multiple concerns, including negligence, human error, and poor conditions. According to Chuwa (2024), secondary infections are a significant threat to patient safety and wellness, reducing an organization’s ability to realize clinical objectives. The facility is a large healthcare provider operating numerous hospitals and care homes across the United States. The organization continues to report increased infection rates across its branches owing to a lack of standardized infection prevention and control protocols, reducing its efficiency and appeal. Internal audits point to inconsistencies in general sanitation, cleanliness, and hygiene. The organization also …

Eeg Pressure Injuries, Paula Ebert

Nursing Grand Rounds

EEG Pressure Injuries. Paula Ebert, MS, RN, CNS, ACCNS-AG, CCRN, SCRN

Objectives:

• Understand the clinical impact of pressure injuries related to EEG
• Understand the implemented changes to reduce pressure injuries related to EEG
• Understand the multidisciplinary approach to addressing the problem

Staff Education To Improve Patient Safety Using Standardized Medication Transcription Verification, Beloved Martey

Walden Dissertations and Doctoral Studies

This staff education project was a quality improvement initiative aimed at reducing medication transcription errors by implementing a standardized verification protocol. The project addressed the critical practice problem of transcription-related medication errors, which contribute to wrong medication administration, adverse drug events, and patient harm. The practice-focused question was: How does implementing a staff education program on standardized medication transcription verification processes in healthcare institutions affect the rate of wrong medication administration compared to traditional transcription methods without education? The project was implemented over 8 weeks in an outpatient clinic with 20 participants (8 prescribers and 12 nurses). The primary data …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Prevalence Of Sexual Harassment Among Nurses And Nursing Students In A Culturally Conservative Country, Hanadi Mohamad Nur Steitiyeh, Fatin Ahmad Safa, Jana Daoud Al Hajj Daoud, Adam Tarek Ikkawi, Sahed Ali Fawaz, Hiba Deek

BAU Journal - Science and Technology

The prevalence of sexual harassment among nurses and nursing students in Lebanon is an unidentified social concern. This study aims to identify this prevalence and assess the related factors. Using a self-administered questionnaire the sociodemographic characteristics, workplace variables, physical appearance, and the Sexual Experience Questionnaire (SEQ) were assessed, the data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A total of 380 participated with 71.8% being female and 63.9% aged between 18 and 25. Sexual harassment was experienced by 91 participants (23.9%) and occurred mainly in the patients’ rooms and during procedures. Policies were absent or …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

Tiny Heart Bundle Qi Project: 3d Modeling To Improve Care Of Cardiac Nicu Patients, Stacy Ranee Harris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background—Infants with congenital heart disease (CHD) are being care for in the neonatal intensive care unit (NICU) by increasing numbers of novice nurses. Understanding complex cardiac anatomy is imperative to novice nurses’ readiness to care. Parents of infants with CHD may not understand their child’s anatomy, which impacts many facets of their care.

Purpose— The purpose of this quality improvement (QI) project was to determine if education, including 3D heart models improved novice nurse readiness to care for NICU patients with CHD and if parental understanding improves after receiving education with 3D heart models.

Methods— This was a plan-do-study-act (PDSA) …

The Impact Of Nurse-Led Distraction Techniques On Pain And Anxiety During Cancer Treatment In Pediatric Oncology Patients: Examining Virtual Reality And Play Therapy, Alexis Abalos

Nursing | Senior Theses

Children undergoing cancer treatment often experience pain and anxiety during cancer treatment, including chemotherapeutic invasive procedures such as frequent port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce levels of pain and anxiety in pediatric oncology patients. This thesis analyzes existing data through a close examination of primary and secondary research articles that prove the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. Using the University of California, San Francisco (UCSF) Symptom Management Theory, …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

Optimizing Efficiency In Joint Injections In An Outpatient Orthopedic Oncology Clinic Using Lean Six Sigma, William Alexander Byrd

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Prolonged in-room wait time in an outpatient orthopedic oncology clinic was identified as an important driver of dissatisfaction and operational inefficiency. Baseline in-room times in this setting were reported as M=96.2 minutes for patients receiving injections and M=92.9 minutes for those not receiving injections. This quality improvement project used Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, Control) framework to streamline clinic workflow for the joint injection process. Over an eight-week period, four key interventions were introduced: a standardized order set for medications, pre-bundled supplies and portable supply toolbox, telephone pre-consenting of patients, and optimized scheduling of …

Comparing The Evolution Of The Advanced Practice Nurse Role: Insights From Switzerland And Kenya, Carole Mackavey, Sara Kohler, Eunice Ndirangu, Rachel Kimani, Constance Shumba, Bernard Mutwiri, Colette Henderson, Anna Jones

School of Nursing & Midwifery, East Africa

The article explores the evolution of Advanced Practice Nurse (APN) roles in Switzerland and Kenya, highlighting their development, challenges, and influence on healthcare delivery. Despite notable differences in income levels and healthcare infrastructure, both countries are committed to strengthening primary care through the deployment of APNs. Switzerland uses APNs to address provider shortages and improve chronic disease management, whereas Kenya uses them to increase access in underserved areas. A comparative analysis explores how regulatory frameworks, educational models, scope of practice, and health system priorities influence the adoption of advanced practice nursing (APN). Switzerland’s established healthcare system supports the integration of …