Digital Commons Network^™

Enhancing Chronic Kidney Disease Awareness And Early Identification Through Community Health Worker Education In Rural Arkansas, Samantha L.M. Smith

Walden Dissertations and Doctoral Studies

The doctoral project was focused on improving staff education and development to prevent chronic kidney disease (CKD) through community health worker (CHW) education. The practice problem was the delayed identification of CKD risk factors and late referral to nephrology services, particularly among rural and underserved populations. Because CKD often progresses without symptoms, early education and awareness are critical to improving outcomes and reducing disease progression. The purpose of the project was to develop and implement a structured CKD educational curriculum for CHWs to improve their confidence in kidney health, CKD risk factors, prevention strategies, early identification, and referral awareness. The …

Pengaruh Buerger Allen Exercise Terhadap Sirkulasi Ekstremitas Bawah Pada Pasien Luka Kaki Diabetik, Jannaim Jannaim, Ridha Dharmajaya, Asrizal Asrizal

Jurnal Keperawatan Indonesia

The Influence of Buerger Allen Exercise on Lower Extremity Circulation in Patients with Diabetic Foot Ulcer. Diabetic footulcer (DFU) is a complication of diabetes caused by impaired venous and arterial blood circulation. Buerger allen exercise is a modality therapy with active postural movement. This study aims to assess the effect of buerge rallen exercise on the circulation of lower extremities in DFU patients. The study design was pre experimental pretest and posttest without control. The sampling technique was consecutive sampling and the large sample of 43DFU patients, analysis data was using Wilcoxon test. Increased circulation is measured using the Ankle …

Dnp Final Report: Community-Based Advance Care Planning Education For Older Adults: A Quality Improvement Project, Teresa Hill

DNP Final Reports

Background: Advance care planning (ACP) supports patient autonomy and promotes care aligned with individual values and preferences. Despite these benefits, fewer than half of adults aged 50–80 have completed formal ACP documentation, and community-dwelling older adults rarely engage in ACP before serious illness, representing a persistent gap in early engagement.

Purpose: This quality improvement (QI) project evaluated the effectiveness of a community-based ACP educational intervention in improving ACP knowledge, confidence, and engagement among older adults.

Methods: A nurse facilitator trained in the Five Wishes framework delivered a structured, 60-minute ACP workshop at a senior center in North Texas. A pre–post …

Enhancing Staff Knowledge Of Prenatal Depression Screening And Follow-Up Protocols, Gladys Ajohmbu Esunji

Walden Dissertations and Doctoral Studies

This staff education project addressed inconsistent staff knowledge of prenatal depression screening and follow-up protocols in an outpatient behavioral health practice serving prenatal patients. Prenatal depression is a nursing practice concern because delayed identification and inconsistent follow-up may affect maternal well-being, infant outcomes, family functioning, and timely access to behavioral health support. The practice-focused question was: According to the evidence, among clinical staff in an outpatient maternal mental health setting, what is the impact of structured staff education on adherence to prenatal depression screening on follow-up protocol knowledge? The purpose was to improve clinical staff knowledge through a structured education …

Dnp Final Report: Enhancing Self-Regulated Learning And Metacognition For First-Semester Undergraduate Nursing Students, Carla S. Biondillo

DNP Final Reports

Background. First-year undergraduate nursing students often struggle to adapt their learning strategies to the higher-order thinking and clinical reasoning demands of nursing education. Ineffective study habits, low academic self-efficacy, and limited self-regulated learning (SRL) skills are consistently identified as predictors of attrition, which ranges from 20–50% nationally and internationally.

Purpose. At an academic medical center in rural East Texas, first-semester students report academic overwhelm and inadequate study strategies, consistent with national trends. A structured, evidence-based faculty coaching intervention targeting SRL and metacognition was found to be feasible within the collaborative, student-centered organizational culture.

Methods. A quality improvement (QI) design …

Exploring Caregiving Choice In The Adult Cancer Population, Jennifer L. Huggins

MUSC Theses and Dissertations

ABSTRACT Purpose Although extensive research examines family caregivers (FCs) across populations, less attention has been paid to how lack of choice in assuming the role affects quality of life (QOL) among FCs of adults with cancer. Understanding choice could guide interventions protecting this invaluable, often invisible workforce. Aims (1) Synthesize what is known about perceived choice among informal caregivers of adults with serious illness; (2) assess relationships between caregiving choice and caregiver QOL, burden, sleep, depression, stress, and social determinants of health; (3) describe experiences of FCs of adults with cancer providing care with no, little, or some choice. Design …

Proposal For A Comprehensive Workplace Violence Program In An Acute Care Facility, Christin V. Timmons

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) in healthcare is a growing threat to caregiver safety, workforce stability, and patient outcomes. At a newly opened acute care facility, the absence of a comprehensive WPV prevention program posed a gap in practice, creating safety risks and regulatory vulnerability. A literature search was conducted using CINAHL, PubMed/ MEDLINE, ProQuest Nursing & Allied Health collection, and Google Scholar. A total of 50 articles were identified with 11 articles meeting all inclusion criteria. Collectively, findings supported comprehensive, multicomponent WPV prevention programs to integrate leadership engagement, structured governance, staff education, environmental controls, and continuous data monitoring to improve safety …

Pedagogy Challenged: A Phenomenological Examination Of Teaching Through A Prolonged Technological Disruption, Jerry Cervantes

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to examine the lived experiences of nursing faculty in a pre-licensure Bachelor of Science in Nursing program who taught during a prolonged technological disruption caused by a ransomware attack at a private college in Ohio. The theories guiding this study were transformative learning theory and resilience theory as they relate to how educators make meaning of disorienting events and sustain professional functioning when established systems fail. Data were collected through semi-structured interviews, a focus group, and reflective journals from purposively selected nursing faculty participants and were analyzed according to the phenomenological procedures …

A Program Proposal For A Leadership-Driven, Evidence-Based, Intentional Rounding Playbook, Jacqueline Butler Brown

Walden Dissertations and Doctoral Studies

Patient experience is a key indicator of healthcare quality. In an acute care hospital in Northeast Georgia, intentional rounding is an established practice. Inconsistent communication, variable leadership engagement, and limited accountability are practice gaps that have reduced its effectiveness in improving patient experience outcomes. A comprehensive literature review using PubMed, CINAHL, MEDLINE, and the Cochrane Library yielded 15 peer-reviewed studies that consistently support intentional rounding as an evidence-based strategy for improving patient satisfaction. As the team leader for this Executive Leadership System Improvement Project, I proposed the development of an Evidence-Based, Leader-Driven Intentional Rounding Program Playbook to standardize enhanced rounding …

Exploring Nursing Students' Experiences Of Simulation-Based Learning In Developing Critical Thinking, Clinical Reasoning And Clinical Judgment In The Management Of Mental Health Patients: A Qualitative Case Study, Irene Bellew

Doctoral Dissertations and Projects

The purpose of this case study was to explore how simulation-based learning experiences shape the development of critical thinking, clinical reasoning, and clinical judgment for associate degree nursing students when caring for patients with mental health needs. It addressed the need to narrow the gap between theoretical knowledge and practical application in clinical settings, enhancing the preparedness of novice nurses. By positioning nurse educators as facilitators of innovative strategies, this study advocates for the integration of simulation-based learning within nursing curricula. Roy’s adaptation model guided the study, and data were collected through observation of simulation sessions, semi-structured interviews, and reflective …

Uncovering The Path To Diagnosis Among Adults With Attention-Deficit/Hyperactivity Disorder: A Constructivist Grounded Theory Mini-Study, Jeffrey D. Whitaker, Rick Zoucha, Melissa Kalarchian

Graduate Student Research Symposium

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical …

Exploring Academic–Practice Partnerships In Community Settings: A Narrative Review, Laura C. Sarver

College of Nursing Faculty Papers & Presentations

Purpose: This narrative review explored the literature on academic–practice partnerships in community settings within prelicensure nursing education. Methods: A search of three databases—MEDLINE, CINAHL, and Scopus—led to the review of 12 articles exploring academic–practice partnerships in community settings within prelicensure nursing education. Results: Emergent themes encompassed components for planning, implementing, and evaluating academic–practice partnerships. Planning themes included completing community assessments, considering financial resources, and identifying guiding frameworks or models. Implementation themes included diverse nursing education and community partners and settings, academic–practice partnership initiatives, and integration of partnerships in prelicensure nursing education curricula. Lastly, evaluation themes included the exploration of a …

Supportive Technology Promotes Research Engagement Among Nurses And Allied Health Professionals, Rachael Haskell, Zoe Samson, Justin Peterson, Kristiina Hyrkas

MaineHealth Maine Medical Center

No abstract provided.

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

Clinical Practice Guideline To Improve Medication Adherence In Adults With Chronic Conditions In Outpatient Settings, Mulumbwa Chishimba

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice project was conducted to develop and assess a clinical practice guideline (CPG) to enhance medication adherence among adult patients with chronic illnesses in an outpatient setting. Adverse health-related outcomes include worsening chronic illness and developing complications, frequent hospital admissions, and rising costs of healthcare services. While some interventions are recommended based on the available literature, most outpatient facilities do not have systematic practices for monitoring and enhancing medication adherence among patients with chronic conditions. The evidence-based question was: What evidence, based on content expert review using the Appraisal of Guidelines for Research and Evaluation II …

Examination Of Maternal Mortality, Mental Health Conditions, And Co-Occurring Factors, Laura Eileen Skaarer

Walden Dissertations and Doctoral Studies

Maternal mortality (MM) continues to be a public health concern in the state of Arizona. There is little to no research investigating the relationship between MM and mental health conditions co-occurring with contributing factors among women who have died in Arizona while pregnant or within 1 year of the end of a pregnancy. The purposes of this quantitative study, guided by the three delays model (3DM), were to examine (a) MM and mental health conditions as the primary underlying cause of death; (b) MM and mental health conditions surrounding death; and (c) significant contributing factors (i.e., discrimination, knowledge, lack of …

Staff Education To Decrease Workplace Violence Through De-Escalation Training In The Emergency Department, Tyrani Anderson

Walden Dissertations and Doctoral Studies

Workplace violence remains a significant issue in healthcare settings, particularly in emergency departments where psychiatric patients may present with aggressive behaviors. Nurses and healthcare staff are frequently exposed to verbal threats, intimidation, and physical aggression, which negatively impact staff safety, job satisfaction, and patient care quality. Despite workplace violence prevention policies, gaps remain in staff preparedness when managing escalating patient behaviors. The purpose of this Doctor of Nursing Practice project was to implement an evidence-based de-escalation training program to improve staff knowledge about managing aggressive psychiatric patients in the emergency department. The practice- focused question was: Can staff education on …

A Charism-Based Faculty Instruction Framework For Nursing Education: Integrating Values-Driven Pedagogy In Blended Learning Environments, Humprey G. Icban, Anele C. Mallari, Cherry B. Lazatin, Aurora R. Valencia, Lilibeth G. Sales, Ulysses J. Rengel, Marie Aileen L. Domingo

The Journal of Faith, Education, and Community

The evolution of nursing education in the Philippines is driven by dynamic global healthcare demands and an accelerated shift toward blended learning modalities. The central challenge lies in preserving the humanistic values of compassion and integrity within technology-mediated environments. This study addresses this issue by developing a Charism-Based Faculty Instruction Framework (CBFIF) designed to empower clinical instructors at the University of the Assumption College of Nursing and Pharmacy (UACONP) in their crucial role as "Formators of Catholic Leaders." The framework is intended to cultivate the institution's core graduate attributes: "Biasa" (academically competent), "Maganaca" (morally upright), and "Mayap" (socially responsible). A …

Nurses’ Knowledge And Practices Regarding Infection Prevention Measures In Cardiac Intensive Care Unit, Marwa G. Abouheiba, Maha Adel Salem, Jean Bertin Mudenge

Nursing

Abstract: Background: Healthcare-associated infections (HAIs) remain a major global patient safety challenge, contributing substantially to morbidity, mortality, prolonged hospitalization, antimicrobial resistance, and increased healthcare costs. Patients admitted to cardiac intensive care units (ICUs) are particularly vulnerable because of their critical illness, frequent exposure to invasive devices, and complex cardiovascular interventions. Nurses play a pivotal role in preventing HAIs through the consistent implementation of evidence-based infection prevention and control (IPC) measures. Therefore, assessing both nurses' knowledge and their observed clinical practices is essential for identifying strengths, potential gaps, and opportunities for quality improvement. Aim: To assess nurses' knowledge and observed practices …

Enhancing Nursing Competency In The Ambulatory Surgery Center, Rachael Owokole

Walden Dissertations and Doctoral Studies

In this project, I addressed a persistent practice problem among agency nurses working in an ambulatory surgery center (ASC) in Southern California, who often enter the facility with varying familiarity with its policies and procedures. I designed this staff education, evidence-based practice (EBP), quality-improvement initiative to strengthen nursing knowledge and competency among agency nurses at the facility. The practice question was designed to assess on whether their knowledge and self-perceived competency improved after participating in the education program. I obtained evidence for the project from peer‑reviewed research, clinical guidelines, and national competency frameworks. I identified sources through systematic searches of …

Staff Education To Instruct Nurses On How To Use The Braden Scale To Increase Their Knowledge, Anna Shedrick

Walden Dissertations and Doctoral Studies

No abstract provided.

Influence Of Dietary Protein On Levodopa Effectiveness, Meghan Decker Rn

Nurse Residency

In adult patients with Parkinson's disease how does carbidopa-levodopa administration with protein vs without protein impact levodopa absorption and patient signs and symptoms?

Improving Patient And Staff Safety During Intrahospital Transport: Implementation Of A Nurse-Driven Checklist, Leah D. Kvintus Rn, Bsn

Nurse Residency

In hospitalized adult patients requiring intrahospital transport, how does the implementation of a standardized nurse-driven transport checklist and structured, facility-wide transport safety protocols compared to current practice without standardization affect patient and staff safety outcomes, including patient falls, safety incidents, and staff injuries or workflow disruption?

Why 4:1 Matters: Addressing Nurse Burnout, Alexandria Ranalletti Bsn Rn, Cecelia Greenleaf Bsn, Rn, Savannah Sheen Bsn, Rn

Nurse Residency

For nurses on medical-surgical floors, how does implementing a 4:1 nurse-to-patient staffing ratio compared to 5:1 or 6:1 staffing ratios impact nurse burnout?

Fall Prevention Education Among Older Adults At Townson Assisted Living Facility (Talf), Yolana Farrell-Williams

Walden Dissertations and Doctoral Studies

Falls in the elderly are a significant cause of injury, disability, and preventable medical expenditure; thus, fall prevention is an issue to assisted living homes like Townson Assisted Living Facility (TALF). The internal incident reports showed that persistent fall incidents were associated with inconsistent knowledge among the staff and unequal observed compliance with fall-prevention guidelines, indicating a practice gap in the systematized education of nurses. Educational interventions are effective in achieving high-quality staff, adherence to protocols, and outcomes concerning falls. Consequently, the current project was conducted to determine whether a specialized falls-prevention education program would enhance the knowledge and competency …

Educating School Nurses On Trauma-Informed Care, Na-Keisha Allene White

Walden Dissertations and Doctoral Studies

Trauma-informed care is a critical component of supporting students' overall wellness, and school nurses are central to this work. They are often the first professionals to recognize when a student is exhibiting a trauma response or experiencing a mental health concern during the school day. Although evidence-based school health organizations have advanced efforts to ensure that academic environments are prepared to support students’ mental health needs, school nurses are too often left out of these strategic planning processes. Their exclusion not only overlooks their clinical expertise but also weakens the school’s ability to respond effectively and holistically to student needs. …

Effect Of Virtual Reality Intervention Of Postoperative Pain In Pediatric Surgical Patients, Tara L. Kempker

Dissertations

Problem: Pediatric surgical procedures are associated with preoperative anxiety. Preoperative anxiety is associated with higher postoperative pain. Multiple studies have found that decreasing preoperative anxiety using Virtual Reality (VR) Intervention also decreases postoperative pain scores and use of rescue analgesics in postoperative care units (PACU). However, there is no standardized protocol for use of VR interventions and in our institution, VR was not utilized at all.

Methods: This quality improvement (QI) initiative utilized a quasi-experimental design and convenience sampling. Quantitative data was collected during visits for scheduled operative visits for pediatric surgical patients ages seven to 18 years …

Psychotropic Medication Use In Older Adults In A Long-Term Care Facility: Implications For Screening Tool, Callie M. Johnson

Dissertations

Psychotropic medication use in older adults aged 65 years and older residing in the long-term care facility has a complex issue in the high use of psychotropic medications. Older adults residing  in long-term care (LTC) facilities are affected and prescribed at least one psychotropic or antidepressant medication.

Enhancing Well-Being: Implementing Weekly Social Interventions For Older Adults In Independent Living, Rosa Huang

Dissertations

Loneliness and social isolation significantly impact the physical and mental well-being of older adults. This quality improvement project implemented an eight-week social intervention designed to reduce loneliness and enhance well-being through weekly sessions incorporating mindfulness exercises, gratitude journaling, and structured socialization activities. The intervention was delivered by nursing students to a sample of residents in a Midwestern independent living community. While most standardized measures of loneliness and mood did not show statistically significant changes, the project resulted in a statistically significant increase in social network engagement as measured by the Lubben Social Network Scale-6 (LSNS-6). The findings suggest that group-based …

Clinical Practice Guideline For Evidence-Based Management Of Chronic Prostatitis, Sandra Castro

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project involved the development, expert appraisal, and implementation of an evidence-based Clinical Practice Guideline (CPG) for chronic prostatitis management in adult male patients at a private outpatient clinic. The practice problem was persistent symptom burden from reliance on antibiotic monotherapy without adjunctive therapies, contributing to recurrent symptoms and decreased quality of life. The purpose was to develop and implement a standardized CPG to improve symptom outcomes and support antimicrobial stewardship. The project question was: In adult male patients with chronic prostatitis, how does a standardized CPG incorporating adjunctive ozone therapy and structured symptom monitoring, …