Digital Commons Network^™

Staff Education To Improve Healthcare Staff Knowledge Of An Electronic Scheduling System In An Intensive Outpatient Program (Iop), Catherine Kinyili

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project aimed to improve staff knowledge of the newly implemented electronic scheduling and booking kiosk system. A transition from a paper-based to an electronic scheduling system led to reduced staff efficiency, communication challenges, scheduling errors, and delays in patient care. An evaluation identified inconsistent staff knowledge of the newly implemented electronic scheduling system. The practice-focused question for the project was: Among healthcare staff in an intensive outpatient program, how does a one-time structured education and training session affect staff knowledge of a new electronic scheduling system? The purpose of this project was to …

Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson

Walden Dissertations and Doctoral Studies

Nurses play a central role in shaping patient experiences through clinical care and relational service behaviors. However, little is known about registered nurses’ perceptions and experiences of relational service behaviors in contemporary health care settings. The purpose of this interpretive description qualitative study was to explore registered nurses’ perceptions and experiences of relational service behaviors and their role in promoting patient-centered care. Herzberg’s two-factor theory provided the conceptual framework for examining how intrinsic motivators and extrinsic workplace factors influence relational engagement. Semistructured interviews were conducted with 11 registered nurses from diverse clinical practice settings. Interview data were analyzed using Braun …

The Experience Of Wellness And Self-Care For Graduating Bsn Students, Jenny Pappas, Terri A. Clark, Tasha Ruffin, Deborah Ellison, Adrienne Wilk, Debra Rose Wilson

Journal of Social, Behavioral, and Health Sciences

The aim of this study was to explore how graduating prelicensure bachelor of science in nursing (BSN) students experience self-care and wellness, with the goal of informing future curriculum development. Nursing students face significant academic, emotional, and sociocultural pressures that heighten vulnerability to burnout. Despite widespread agreement that self-care is a professional expectation, little is known about the students’ experience within demanding programs. Guided by Orem et al.’s (2001) self-care deficit theory, a qualitative study using interpretive hermeneutic phenomenology was used to examine lived experiences of self-care and wellness. Sixteen graduating BSN students participated in in-depth, semistructured interviews. Interviews were …

Don’T Fall For It: Just-In-Time Staff Education To Reduce Patient Falls On An Adult Telemetry Unit, Forrest Wilcox, Kyle Knight, Jennifer Paiz, Zaira Garcia-Vega

Master's Projects and Capstones

Objective: Patient falls remain a leading cause of preventable harm among hospitalized adults and carry significant clinical and financial consequences. On an adult medical-surgical telemetry unit at this study site, a one-year review of 45 fall events found that most falls occurred among patients classified as high risk on the Morse Fall Scale, frequently without continuous observation or consistent purposeful rounding. Aim: The aim of this project is to reduce falls on the telemetry unit to the national benchmark of 3.2 falls per 1,000 patient days within a 6-month period. Methods: A just-in-time (JIT) education intervention was delivered to registered …

The Evaluation Of The Epic Epidural Assessment Event And The Effects Of The Conversion Of Epidural To General Anesthesia For Cesarean Sections, Rebecca Turney, Bridget Shinnick

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Unplanned conversion from labor epidural analgesia to general anesthesia (GA) for cesarean delivery is associated with increased maternal and neonatal risk and may occur when inadequate epidural function is not recognized before operative delivery. This Doctor of Nursing Anesthesia Practice quality improvement project evaluated implementation of the Epic Epidural Assessment Event, a structured electronic medical record documentation tool designed to standardize epidural assessment during labor at a high-acuity obstetric referral center in Western Pennsylvania. Using a Plan-Do-Study-Act framework, the project compared pre- and post-implementation epidural-to-GA conversion trends, reviewed Epic audit data for documented tool utilization, and collected anonymous anesthesia provider …

Implementation Of A Discharge Planning Protocol, Sylvia Ngwikooh Forku

Walden Dissertations and Doctoral Studies

This doctoral project was a nursing led quality improvement initiative focused on standardizing discharge planning on an adult inpatient psychiatric unit. The goal of the project was to strengthen evidence-based, person-centered transitions of care to reduce readmissions and promote safer community reintegration for adults with serious mental illness. The practice focused question guiding this project was whether implementing an evidence based, standardized discharge planning protocol on an adult inpatient psychiatric unit would improve staff knowledge and adherence to best practice discharge elements and contribute to a favorable decrease in 30-day readmission rates. Analytical strategies included descriptive analysis of pre and …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

Staff Education To Improve Confidence Of Triage Decision-Making In Hospice After-Hours Care, Kelly Hurst

Walden Dissertations and Doctoral Studies

A quality improvement project addressed variability in after-hours hospice telephone triage through implementation of structured communication and symptom-based decision-support tools. The practice-focused question examined hospice triage nurses’ perceived confidence following implementation of these tools. A descriptive quality improvement design was used. Five hospice triage nurses received education on the CALMER communication technique and symptom-specific decision-support guides for anxiety and dyspnea. Outcomes were evaluated through a postimplementation survey assessing confidence, tool utilization, intervention perceptions, and practice recommendations. Quantitative responses were summarized using descriptive statistics, and qualitative responses were reviewed for themes. All participants reported high baseline confidence in hospice telephone triage. …

Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu

Walden Dissertations and Doctoral Studies

The utilization of substance use disorder (SUD) screening tools at the practice site was inconsistent, contributing to limited identification and diagnosis of SUDs. The project was conducted at a psychiatric outpatient clinic in an urban region of Maryland that serves many patients with co-occurring mental health and substance use disorders. The purpose of the project was to develop, implement, and evaluate a staff education program focused on the Drug Abuse Screening Test (DAST-10). The primary goal was to improve staff knowledge and understanding of the DAST-10 screening tool. A 14-item multiple-choice questionnaire was administered before and after the educational intervention …

Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey

Walden Dissertations and Doctoral Studies

Many nurses receive little formal instruction about trauma-informed principles and their practical application in behavioral health settings. To address this practice gap, the project implemented a staff education program for staff at an intensive outpatient program (IOP) and a partial hospitalization program (PHP) located in a northeastern state. The aim was to increase staff knowledge and confidence in trauma-informed principles within clinical practice. The education program emphasized the relevance of trauma-informed care (TIC) in outpatient behavioral health settings, its principles, and its application in nursing assessments, therapeutic communication, and patient interactions. A pretest and posttest questionnaire consisted of 12 multiple-choice …

Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening condition that can rapidly lead to organ dysfunction, septic shock, and death if not recognized and treated early. Older adults in skilled nursing facilities (SNFs) are especially vulnerable because of age-related physiological changes, chronic conditions, weakened immunity, and increased exposure to infections. Consequently, sepsis remains a major cause of hospital readmissions, mortality, and healthcare utilization among SNF residents. The SNF serving as the site for this Doctor of Nursing Practice (DNP) project experienced increased hospital readmissions associated with recurrent sepsis, highlighting the need for a standardized, evidence-based approach to sepsis recognition and management. The practice-focused question …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Implementation Of Staff Education To Reduce Or Prevent Pressure Injury, Beverley A. Moses

Doctoral Dissertations and Projects

Pressure injuries (PIs) present a significant clinical challenge in healthcare settings, particularly among patients with limited mobility, comorbidities, and complex musculoskeletal injuries. These injuries lead to adverse patient outcomes, such as increased morbidity, prolonged hospital stays, and an increase in healthcare costs. Despite advancements in clinical practice, PI prevention remains a critical area for quality improvement, necessitating a standardized, patient-centered approach to care. This Doctor of Nursing Practice (DNP) project aimed to improve patient outcomes by implementing a standardized educational initiative for nursing staff in a bone and joint unit at a private hospital in Upstate New York. The project …

Staff Education To Primary Care Staff About The Standardized Asthma Control Test, Paulina Asiedu

Walden Dissertations and Doctoral Studies

Staff Education to Primary Care Staff About the Standardized Asthma Control Test by Paulina Asiedu Walden University, 2026. Background Inconsistent primary care asthma tracking leads to reactive management and avoidable emergency utilization. At a Minnesota community clinic, baseline electronic health record (EHR) audits revealed validated Asthma Control Test (ACT) scores were documented in only 5% of eligible encounters, driving a 12% emergency department utilization rate. Purpose & Methods This Doctor of Nursing Practice quality improvement project evaluated whether educating primary care staff on a standardized ACT protocol improved clinical knowledge, behavioral intent, and documentation compliance. Using ADDIE and ADKAR change …

Implementing A Structured Lifestyle Counseling Program To Improve Weight Management In Obese Adults Ages 18–65 Within The Private Primary Care Setting, Ntoge Sone Penda

Walden Dissertations and Doctoral Studies

Obesity is a major public health concern that affects millions of adults. As a chronic, progressive disease, obesity increases the risk of developing several medical conditions. Although evidence-based clinical practice guidelines recommend comprehensive lifestyle modification as a first-line treatment, implementation of structured lifestyle counseling in primary care remains inconsistent. The practice-focused question guiding this Doctor of Nursing Practice (DNP) quality improvement project was: Among obese adults aged 18–65 years in a private primary care setting, does implementing a structured lifestyle counseling program improve body weight and body mass index (BMI) outcomes over an 11-week period? An organizational change process guided …

Improving Interdisciplinary Healthcare Staff Confidence And Competence In Screening, Brief Intervention, And Referral To Treatment Through Standardized Sbirt Training In A Behavioral Health Facility, Grace Kakie Awo Aidoo

Walden Dissertations and Doctoral Studies

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach for the early identification and management of substance use concerns. However, inconsistent implementation may occur when healthcare staff lack confidence and competence in applying SBIRT in clinical practice. This Doctor of Nursing Practice staff education project addressed a practice gap related to low confidence and competence among interdisciplinary healthcare staff implementing SBIRT in a behavioral health facility. The purpose of the project was to implement and evaluate a standardized SBIRT education and competency-based training program. Guided by the Johns Hopkins evidence-based practice model, the educational intervention incorporated evidence-based …

Guideline For Early Identification Of Chronic Kidney Disease In At-Risk Adults In Primary Care, Catherine Ugo

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on developing and validating a clinical practice guideline (CPG) to improve the early identification of chronic kidney disease (CKD) among at-risk adults in a primary care practice. The project addressed a site-specific practice gap involving the inconsistent use of evidence-based CKD screening, particularly estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) testing, which may delay diagnosis and treatment (Kidney Disease: Improving Global Outcomes [KDIGO] CKD Work Group, 2024). The purpose of this project was to develop an evidence-based CPG and evaluate its quality using the Appraisal of Guidelines for Research and …

A Soft-Skilled Leadership Development Course For New Nurse Managers, Kiadrick Roshelle Hood

Walden Dissertations and Doctoral Studies

New nurse managers are stepping into leadership roles without structured training. While organizations offer various onboarding courses for managers transitioning into new management roles, few have implemented a structured, evidence-based program focused on leadership development, particularly in the soft leadership skills needed to lead a diverse workforce. I designed this staff education project to determine whether implementation of a leadership development course focused on time management, prioritization, and delegation would improve new nurse managers’ self-perception of these leadership skills. To address this gap, I developed a 1-day leadership development course to introduce tools to improve new nurse managers’ time management, …

Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed a practice gap involving limited education on frailty assessment and senior surgical safety within the general surgery department of a large, integrated healthcare system. Frailty is associated with increased postoperative complications, hospitalizations, readmissions, and mortality among older adults, making early recognition essential to improving surgical outcomes. The practice-focused question project was: Does education on frailty screening and senior surgical safety improve the knowledge, confidence, and intent of general surgery staff in a large, integrated health system? The purpose was to develop, implement, and evaluate an evidence-based educational intervention. The project was guided by the …

Staff Education To Improve Blood Pressure Reassessment And Referral Practices In An Urgent Care Setting, Carolyn Denise Kluttz

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education and quality improvement initiative designed to improve blood pressure (BP) reassessment and referral compliance among adult patients presenting with elevated BP readings in an urgent care setting. Elevated blood pressure is frequently identified during urgent care visits; however, provider responses and follow-up recommendations are often inconsistent, creating missed opportunities for early identification and intervention. The practice-focused question guiding this project was: In adult patients presenting to urgent care settings, how does implementing a standardized nurse-led hypertension screening and referral protocol, compared with usual care, affect the identification and follow-up …

Staff Education To Improve Knowledge Of Standardized Scheduling In A Certified Home Health Agency, Roger Nounamo Kamkoumeu

Walden Dissertations and Doctoral Studies

In this staff education project, I addressed the concerning rate of missed patient visits in home healthcare settings. At the practicum site, there has been no education program addressing scheduling and communication best practices for staff. The practice-focused question guiding this project was: Among nursing staff in a home health agency, does implementation of a staff education program on a standardized scheduling and reminder protocol, improve staff knowledge of missed visit reduction practices? The purpose of the project was to evaluate the effectiveness of the staff training on staff knowledge of scheduling, communication, and reminder protocols for the reduction of …

Addressing Implicit Bias Toward Patients With Substance Use Disorders Through A Staff Education Quality Improvement Initiative, Jeanne Baleng Okuwobi

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education quality improvement (QI) initiative designed to reduce implicit bias among healthcare providers toward patients with substance use disorder (SUD) at a community mental health center. Provider implicit bias toward patients with SUD contributes to stigma, inequitable care, reduced treatment engagement, and poorer health outcomes; addressing this bias is essential to advancing patient safety, health equity, and quality nursing care. The practice-focused question guiding this project asked whether a 9-week evidence-based staff education program incorporating didactic instruction and reflective practice would reduce provider implicit bias toward patients with SUD compared with current practice, which …

Staff Education On Improving Medication Adherence, Oneil Dobgima Galega

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in an outpatient behavioral health setting involving inconsistent use of structured communication strategies to support medication adherence among psychiatric patients. Although nurses routinely provided medication instructions, approaches such as motivational interviewing and psychoeducation were underutilized, limiting patient engagement, understanding, and adherence, and ultimately affecting care continuity and outcomes. The purpose of the project was to improve psychiatric nurses’ knowledge and intent to use motivational interviewing and psychoeducation to enhance medication adherence. The guiding practice-focused question examined whether a structured educational intervention could strengthen nurses’ competencies in these communication strategies. …

Staff Education To Improve Nursing Knowledge On Pressure Injury Prevention, Kheeda Kimberly Gopaul

Walden Dissertations and Doctoral Studies

Staff education in this project was focused on improving nursing staff’s knowledge on pressure injury prevention, inspired by the persistent care quality gap. The gap in practice as of 2024 related to hospital-acquired pressure injury (HAPI) at the host health organization was reported to be approximately 0.2 per 1,000 discharges. It was apparent that education could benefit the nursing staff to improve their knowledge in pressure injury prevention. The education in service focused on continuous nursing skin assessments, to ensure over prolonged hospitalization, patients’ skin does not deteriorate with the development of pressure injuries or advancing of pre-existing pressure ulcers. …

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …

Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet

Walden Dissertations and Doctoral Studies

Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …

Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu

Walden Dissertations and Doctoral Studies

This staff education project addressed a persistent gap in the delivery of integrated physical and mental healthcare for patients with co-occurring conditions. Fragmented care in primary care contributes to untreated mental health needs, increased patient distress, higher costs, and poor outcomes. The aim of this project was to develop, deliver, and evaluate a staff education program equipping nurses, nurse practitioners, and interdisciplinary team members with the knowledge, skills, and practical strategies needed to improve behavioral health integration in primary care. The practice question was, among interdisciplinary staff in a community health setting, did the implementation of an evidence-based, ADDIE-designed staff …

Staff Education For Medication Adherence Among Adults With Major Depressive Disorder In A Private Outpatient Psychiatric And Mental Health Practice, Judith Timbui Eta

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to improve medication adherence among adults with major depressive disorder (MDD) in a private outpatient psychiatric and mental health practice. Medication nonadherence remains a significant barrier to effective depression treatment and is associated with symptom relapse, increased healthcare utilization, and poorer patient outcomes. Evidence supports provider education as an effective strategy for improving adherence-related practices. The project examined whether a targeted educational intervention could improve staff knowledge and confidence in promoting medication adherence over a 12-week implementation period. Guided by the Johns Hopkins Evidence-Based Practice Model and the …

Staff Education To Improve Consistent Phq-9 Administration In An Outpatient Psychiatric Practice, Ngozi Eboru

Walden Dissertations and Doctoral Studies

Depression is a leading cause of disability and is associated with functional impairment, reduced quality of life, and increased healthcare utilization. Consistent administration of the Patient Health Questionnaire-9 (PHQ-9) is an essential component of measurement-based care, supporting the identification, monitoring, and treatment of depressive symptoms. A retrospective chart review at a private outpatient psychiatric practice identified inconsistent PHQ-9 administration and documentation, with a baseline completion rate of 62%. The purpose of this Doctor of Nursing Practice staff education project was to evaluate the impact of a structured educational intervention on the consistency of PHQ-9 administration among staff involved in the …

Preventive Interventions Targeting Social Determinants Of Health: Implications For Healthcare Utilization And Cost, Audrey Wrinkle

NEXUS: The Liberty Journal of Interdisciplinary Studies

Preventive interventions targeting social determinants of health could reduce avoidable healthcare utilization and positively impact long-term cost outcomes within healthcare systems. Evidence indicates that financial and social barriers to preventive care lead to delayed treatment and increased use of high-cost healthcare services in the long term. Preventive interventions focusing on upstream social factors, like home-based care and digital health programs, could improve patient outcomes and reduce avoidable service utilization. Also, incorporating social needs data into policy creation could promote better allocation of healthcare resources. This research highlights the role of prevention-focused strategies in promoting cost-effective, sustainable healthcare delivery.