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Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Peter Mufua Tumenta 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. Melanie Braswell, Committee Chairperson, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2026 Executive Summary Falls are a significant patient safety concern among older adults in long-term care (LTC) facilities. This Doctor of Nursing Practice quality improvement project implemented and evaluated a standardized, evidence-based multifactorial fall-prevention staff education program to improve …

Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba

Walden Dissertations and Doctoral Studies

This staff education project addressed the gap in standardized knowledge and implementation of evidence-based sleep hygiene interventions among nursing staff on an inpatient behavioral health unit. Sleep disturbances affect 80%–90% of psychiatric patients and directly impact treatment outcomes and recovery. I developed the practice-focused question to consider whether an evidence-based sleep hygiene education program would enhance the awareness, knowledge, and practices of the nursing staff regarding sleep hygiene interventions. A thorough literature review of 23 high-quality sources formed the background for the development of a structured educational intervention that encompassed assessment methodologies, nonpharmacological interventions, environmental interventions, and patient education interventions. …

Integrating Interprofessional Education To Strengthen Team-Based Mental Health Care, Adebisi Tijani

Doctor of Nursing Practice Projects

Fragmented interprofessional collaboration in outpatient mental health settings compromises care coordination and patient engagement. This quality improvement (QI) project implemented a structured interprofessional education (IPE) workshop series to improve team collaboration and reduce patient no-show rates in an outpatient mental health clinic. Guided by Bandura's Social Cognitive Theory and Lewin's Change Management Model, the project used a pre-post, single-group design with 12 licensed mental health professionals. The team measured collaboration with the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II) and collected aggregate patient no-show rates from the electronic health record. The intervention consisted of four monthly, one-hour workshops covering role …

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

Nurse-Led Remote Patient Monitoring In Outpatient Heart Failure, Jackline Ukadike

Walden Dissertations and Doctoral Studies

Chronic heart failure (HF) remains a leading cause of avoidable hospital readmissions and emergency department visits due to delayed recognition of early symptom exacerbation between routine outpatient encounters. This doctoral quality improvement project evaluated whether the implementation of an evidence-based, nurse-led remote patient monitoring (RPM) standard operating procedure (SOP) improved early identification of symptom exacerbation compared to standard episodic care among adult heart failure patients (NYHA Class II–III) in an outpatient primary care setting over a 10-week period. Guided by the Plan-Do-Study-Act (PDSA) framework, an evidence-based clinical practice guideline (CPG) and escalation protocol were developed and appraised by a 3-member …

Staff Education On Teaching Evidence-Based Chronic Pain Management, Valdane Eleonu Robinson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on educating providers to fill in knowledge gaps in how to effectively manage chronic pain. The lack of knowledge about the evidence-based recommendations for treating chronic pain was the practice gap. Standardized training protocols to instruct pain management professionals and address disparities in chronic pain management care should be in place to guarantee that all patients in need of chronic pain management have access to culturally appropriate education.

Enhancing Hiv Knowledge And Resource Awareness Among Chief Nursing Officers, Susan Louise Cooper Bailey

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) remains a significant public health concern in rural communities, where limited specialty care, geographic isolation, transportation barriers, and stigma may delay testing and entry into care. The Texas Panhandle is a geographically expansive rural region served by rural hospitals with limited resources. Although area HIV services are available, they are inconsistently utilized. Although chief nursing officers (CNOs) influence practice and care coordination, knowledge gaps regarding HIV guidelines, prevention strategies, and regional resources may limit identification, referral, and continuity of care. The purpose of this doctor of nursing practice (DNP) project was to determine whether a targeted …

Development Of An Evidence-Based Clinical Practice Guideline For Glp-1 Medication Management And Weight-Loss Monitoring In Adults, Jeannette Mariela Pena

Walden Dissertations and Doctoral Studies

This doctor of nursing practice project addressed the lack of a standardized clinical practice guideline for glucagon-like peptide-1 (GLP-1)-based medication management and weight-loss monitoring in an outpatient functional health setting. The purpose was to develop an evidence-based guideline to improve provider consistency, patient education, monitoring, documentation, and treatment safety for adults receiving GLP-1-based weight-management therapy. The Johns Hopkins Evidence-Based Practice Model guided question development, evidence appraisal, synthesis, translation, and implementation planning. The guideline incorporated evidence related to adult obesity management, GLP-1-based pharmacotherapy, lifestyle intervention, eligibility assessment, medication selection and titration, adverse-effect monitoring, follow-up, and documentation. Three content experts—a nurse practitioner …

Palliative Care Consults In The Intensive Care Unit, Kyra Zimmer

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Intensive care unit (ICU) patients often face serious illness or terminal diagnoses requiring invasive monitoring and life-sustaining treatments. Palliative care (PC) supports patients and their families by focusing on improving quality of life, goals of care, and symptom management. It is estimated that 14-20% of ICU patients in the United States could benefit from palliative care consults (PCCs) with potential savings of $6 billion per year. Nurses caring for these patients face unique ethical challenges and may develop secondary post-traumatic stress, emotional strain, burnout, and compassion fatigue.

Review of Literature: The review of literature supported a structured …

Reimagining Clinical Education: Interprofessional Simulation And Clinical Skill Readiness In Nursing And Occupational Therapy Curricula, Gretchen Johnson, Linda Barnett, Lori Aaron-Brija, Emily Berkowitz

Internet Journal of Allied Health Sciences and Practice

Purpose: As the healthcare landscape evolves, education for health professionals must prepare future practitioners to meet emerging challenges and navigate diverse care settings. Integrating interprofessional education (IPE) opportunities within healthcare curricula supports the development of essential clinical skill competencies and collaboration across multiple disciplines. The Clinical Skill Readiness interprofessional model prepares students for successful clinical rotations by integrating assessment and skill development. Students develop vital interprofessional skills, with specific emphasis on communication, professionalism, and role clarity, all of which are essential for effective practice in a collaborative clinical setting. Methods: Nursing and occupational therapy students participated in timed treatment sessions …

Forty Years In The Making: Reporting On The Co-Creation Of A National Roadmap For Birthing On Country Services For The Best Start To Life, Res Mccalman, Anneka J. Bowman, Roianne West, Kristie Watego, Jyai Allen, Claire Clack, Sue Kildea, Sue Kruske, Melanie Briggs, Cleone Wellington, Rebecca Coddington, Yu Gao, Isabella Garti, Sascha Kowalenko, Sarah Ireland, Catherine Austin, John D. Boffa, Marah Prior, Kelsie Kahl, Bettina Chaseling, Sarah Khaw, Emily Armstrong, Donna Hartz (Kamilaroi), Yvette Roe (Njikena Jawuru)

Research outputs 2022 to 2026

For over 40 years, First Nations communities in Australia have called for community-controlled birthing and maternal–infant health programs that restore First Nations-led, community-controlled birthing systems grounded in cultural authority and sovereignty. ‘Birthing on Country’ services have demonstrated improved First Nations maternal–infant health outcomes, more babies kept out of the child protection system, and reduced health system costs. Restoration and expansion of Birthing on Country services across regions has been inconsistent, and has lacked support for national implementation. In 2022, a large national gathering (‘Best Start to Life’) was co-hosted in Mparntwe (Alice Springs). The focus was Birthing on Country service …

Towards Primary Health Care Education Reform: A Reflexive Thematic Analysis Of Nursing Supervisors' Perceptions, Experiences And Challenges, Debbie Procter, Mccullough, Debbie Massey, Karen Strickland

Research outputs 2022 to 2026

Aim: To explore Primary Health Care nurses' experiences of supervising nursing students on clinical placements and their perceptions of academic preparation for placement and future employment. Background: Primary Health Care nurses are essential workers within sustainable health systems but pre-registration educational preparation and access to clinical experiences can be limited. Previous research correlates positive clinical experiences with workforce intentions. Furthermore, nursing supervisors are pivotal to maximising student experiences and education, yet little is known about their perceptions, challenges, and views about how current curriculum prepares students to commence professional careers in primary care. Understanding their perceptions may inform curriculum, improve …

Impact Of Exercise On Mental Health In Inpatient Settings, Samuel Blake Rn, Nathaniel Clark Rn

Nurse Residency

In adult psychiatric inpatients with mental illness, how does participation in a structured exercise program compared with standard inpatient care affect depression, anxiety, and overall mental health outcomes during hospitalization?

Night Shift-Specific Training & Engagement, Keith Procell Rn, Kyleigh Keitel Rn

Nurse Residency

In night shift hospital workers (P) does mandatory daytime attendance for required education (I), compared to shift-aligned, asynchronous, or flexible scheduling of education (C), increase health risks associated with circadian disruption (O), as supported by current research?

Neonatal Assessment And Vr: Designing 3d Simulation Training For Prehospital Clinicians, Michella G. Hill, Luke Hopper, Belinda Flanagan, Sara Hansen, Alecka Miles, Jess Watson, Sean Cashman, Kirstie Balding, Peggy Dysktra, Joshua Johnson, Brennen Mills

Research outputs 2022 to 2026

Prehospital emergency care requires clinicians to manage a vast array of medical and trauma incidents, including rare events such as obstetrics (i.e., childbirth) emergencies. Emergency births can have life-threatening complications such as neonatal respiratory distress potentially leading to cardiopulmonary resuscitation. Management of low-frequency high-risk (LFHR) events such as birthing and immediate neonatal care occurring outside the planned place of birth require expert clinical management. Underutilised skill and knowledge of LFHR events decay within 12-months of being taught. LFHR events are often overlooked for refresher training due to the low occurrence of such cases, putting LFHR patients at even greater risk …

Nurses' Perspectives Of Dysphagia Screening Practices In Irish Residential Long-Term Care Settings: A Qualitative Descriptive Study, Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney

Research outputs 2022 to 2026

Objectives To examine nurses’ perspectives on current dysphagia screening practices in Irish residential long-term care settings (RLTCS), and to investigate barriers and facilitators to nursing-led dysphagia screening within this healthcare context. Methods This study employed a qualitative descriptive design and was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Participants were recruited through purposive sampling from RLTCS located in the northeast of the Republic of Ireland. Eleven in-person focus group interviews were conducted with thirty-four nurses working in clinical and managerial roles. A semi-structured interview guide was utilised, and the data were subsequently analysed using reflexive …

Pediatric Nurses' Perspectives Of Integrating Spiritual Care Into Everyday Practice: An Integrative Review, Yin May Htay, Mandie Foster, R. Mowat

Research outputs 2022 to 2026

Aim: To explore nurses' perspectives regarding children's spiritual care in pediatric healthcare settings. Background: Spiritual care is a fundamental source of comfort and healing and an essential. component of nursing practice. However, pediatric nurses often lack the competence and confidence to incorporate spiritual care into their clinical routines. Despite its importance, the perceptions and practices of pediatric nurses across various clinical specialties regarding spiritual care remain underexplored in current literature. Methods: The integrative review methodology was chosen to provide a comprehensive and up-to-date synthesis of the literature. Four electronic databases (CINAHL, MEDLINE, Scopus and Google Scholar) were used to search …

Culturally Safe Nursing: Transformative Learning Experiences Through Critical Reflection Assessment, Lesley Andrew, Michelle Pedlow, Bev Ewens

Research outputs 2022 to 2026

Aim: To explore the transformative learning experiences of postgraduate nursing students engaging in an Aboriginal culture and history module, through an analysis of a critical reflection assessment, in particular the student development of cultural awareness and culturally safe practice.

Background: Despite mandated inclusion of Aboriginal cultural content in Australian nursing curricula, culturally unsafe practices and racism persist. Transformative learning, underpinned by critical reflection, can challenge fixed assumptions and promote cultural awareness and culturally safe care.

Design: A qualitative descriptive study using thematic analysis. Methods: Written critical reflections from 15 consenting postgraduate nursing students who completed the Ngany Kalyakal Katatjiny Boordawan …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …

Tracking Towards Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Carolina Maria Gerodias Cayetano

Master's Projects and Capstones

Background: Central line-associated bloodstream infections (CLABSIs) remain among the most serious and costly healthcare-associated infections in acute care settings, with each event associated with significant excess mortality, prolonged hospital stays, and avoidable healthcare costs. At Hospital A, a 239-bed acute care facility, two of six total CLABSI events over a 12-month period were associated with peripherally inserted central catheters (PICCs), representing 33% of all facility CLABSIs and exposing a critical gap in standardized PICC line surveillance and maintenance bundle monitoring.

Problem: The PICC team lacked a systematic, real-time tracking mechanism to monitor central line maintenance bundle adherence across seven adult …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi

Walden Dissertations and Doctoral Studies

The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …

Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh

Walden Dissertations and Doctoral Studies

Patient falls remain a major patient safety concern, particularly among hospitalized stroke patients who are at increased risk because of impaired mobility, neurological deficits, and cognitive changes. The inpatient stroke unit selected for this quality improvement project consistently reported the highest fall rates within the hospital system, highlighting the need for evidence-based interventions. The purpose of this project was to determine whether a structured fall-prevention education program incorporating evidence-based practices and the 4Ps of purposeful rounding (pain, potty, position, and possessions) would improve staff knowledge, increase compliance with fallprevention practices, and reduce patient falls over a 2-month period. Guided by …

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Advancing Paternal Perinatal Mental Health: Integrating Qualitative Evidence, Theory, And Measurement Science, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Aim: To advance understanding of paternal perinatal mental health through the integration of qualitative evidence, mid-range theory, and conceptual framework development.

Background: Existing scholarship largely emphasizes prevalence and symptom identification of paternal post partum depression, with limited integration of fathers lived experiences into theory development and assessment frameworks, and mental health nursing practice. Greater integration of qualitative evidence, theory, and measurement science may strengthen the recognition and assessment of paternal distress.

Methods & results: This integrative paper synthesizes findings from a phenomenological study of fathers with postpartum depression, the Reciprocal Adaptation in Postpartum Fathers mid-range nursing theory, and the P- …

Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education project regarding Candida auris, a multidrug-resistant fungus recognized by the Centers for Disease Control and Prevention (CDC) as an urgent global health threat due to its high mortality, environmental persistence, and resistance to common disinfectants. Staff play a crucial role in infection prevention; however, limited awareness and inconsistent knowledge of Candida auris contribute to potential transmission in skilled nursing home settings. The project question was as follows: Among staff members in a skilled nursing facility, does an evidence-based educational intervention improve knowledge of Candida auris infection prevention as compared pre- …