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Staff Education To Improve Knowledge On Early Recognition Of Staff Burnout In Nurses Working In Long-Term Care, Geraldine Ndeng Akonwah

Walden Dissertations and Doctoral Studies

This doctoral project was a practice-based staff education project aimed at educating nurses concerning early burnout recognition. The educational intervention was chosen to promote awareness and knowledge related to the concept of burnout and self-care among nurses employed in a long-term care facility. The practice problem addressed was the high prevalence of nurse burnout and the limited ability of nurses to recognize early signs of burnout. The problem is significant in nursing practice as burnout is detrimental to the clinical judgment, patient safety, job satisfaction and staff retention. The guiding question of the project was as follows: Does a staff …

Understanding Reporting Decisions: Qualitative Exploration Of Hate Crime Underreporting Among Minority Transgender Individuals, Shanise Anita Benitez

Walden Dissertations and Doctoral Studies

Minority transgender individuals experience disproportionately high rates of hate‑motivated violence, yet these incidents remain substantially underreported. This qualitative study examined the social, structural, and identity‑based factors that influence reporting decisions among minority transgender adults in the United States. Guided by Bandura’s social learning theory and Crenshaw’s intersectionality theory, the study examined how participants’ lived experiences, community-based observations, and intersecting marginalized identities influence their perceptions of safety, trust, and institutional legitimacy. Semi‑structured interviews with minority transgender participants were analyzed using thematic analysis to identify patterns related to reporting behaviors, community‑driven coping strategies, and barriers to formal engagement with law enforcement. Findings …

Faculty Perceptions About The Challenges Of Declining Enrollment In A Caribbean University, Courtney Palmer

Walden Dissertations and Doctoral Studies

The precipitous decline in enrollment is a concerning aspect of higher education. The problem addressed in this study was that faculty members at a local university on a Caribbean island have faced an approximate 44% reduction in student enrollment over the past six years. Guided by the new learning compact framework (NLC), the purpose of this basic qualitative study was to explore industrial technology lecturers' perceptions from one Caribbean Island university about the challenges they experience from declining enrollment and examine their suggestions to improve enrollment. Twelve lecturers with tertiary-level teaching experience at the institution were interviewed using semi-structured interviews. …

Emergency Nurses’ Perspectives On Workload, Stress, And Violence In The Context Of The U.S. Nursing Shortage, Wanda Marie Haynes

Walden Dissertations and Doctoral Studies

The nursing shortage is a critical global issue that significantly impacts emergency nurses (ER), leading to increased workloads, psychological stress, and heightened exposure to workplace violence (WPV). This phenomenon raises concerns among healthcare administrators and nurse leaders who seek strategies to improve retention and ensure quality patient care. The purpose of this qualitative study was to explore the meaning of workload, stress, and WPV among ER nurses during the U.S. nursing shortage. Guided by Herzberg’s two-factor theory, the study employed a phenomenological approach to capture nurses’ lived experiences. Data were collected through semi-structured interviews with eight ER nurses from diverse …

Understanding Interventions For Generational Trauma From The Experienced Counselors’ Perspective, Christina Ann Cartagena

Walden Dissertations and Doctoral Studies

Healing generational trauma involves counselors’ understanding and recognizing the symptoms of unhealthy coping mechanisms in adults who witnessed adverse emotional reactions as children. Generational trauma occurs when generations have trouble building healthy relationships and pass unhealthy coping mechanisms to future generations. There has been a reported increase in youth and adults seeking mental health services for generational trauma. The problem was that there was insufficient information about how counselors recognize and respond to the symptoms of generational trauma or what treatment methods or modalities to use to support patients. The purpose of this generic qualitative study was to explore the …

Mental Health Impacts Of Racism And Limited Diversity In Christiansburg, Virginia, Shuchi Sanyal

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

In this portfolio, I identify and address the prevention needs of racially and ethnically marginalized adolescents in Christiansburg, Virginia, examining how racism and limited diversity affect mental health and proposing culturally responsive, developmentally appropriate prevention strategies.

Significant Findings

Adolescents of color in predominantly White, semi-rural communities face racial isolation, microaggressions, and limited culturally responsive supports, increasing risk for anxiety, depression, and identity-related distress. Using a social-ecological framework, findings show that individual vulnerability is influenced by school climates, relationships, and community norms that may minimize racialized experiences. Protective factors include relational safety, identity affirmation, mentorship, and trauma-informed practices. Evidence-based …

Improving Staff Knowledge Regarding Fall Prevention Guidelines In An Acute Care Setting, Opeyemi Adebayo

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education initiative aimed at addressing gaps in the implementation of evidence-based fall prevention practices among nursing staff in an acute care hospital setting. Despite the availability of established fall prevention guidelines, inconsistent staff adherence to protocols continues to place patients at risk. This project was guided by the practice-focused question: Does nursing staff education on fall prevention guidelines improve nursing knowledge as compared to pre- to post-education? The purpose of the project was to develop a comprehensive resource to enhance nursing staff's knowledge of fall prevention guidelines. The Johns Hopkins evidence-based …

Proposal For An Intensive Outpatient Program, Dorcas Olatokunbo Ogundemuren

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) executive leadership systems improvement program presents the design of an evidence-based intensive outpatient program (IOP) in a community psychiatric clinic in the central region area of Maryland, to address the practice problem of fragmented transitions from inpatient psychiatry to routine outpatient services. This practice gap contributes to avoidable 30-day readmissions and prolonged emergency department boarding. The guiding practice question was as follows: In behavioral health organizations, how does a leadership-driven IOP implementation affect care transitions, staff engagement, and protocol adherence compared with existing discharge workflows? Local organizational indicators reveal elevated psychiatric readmission rates and …

Nurse-Led Telehealth Quality Improvement Initiative For Chronic Disease Management In Rural North Dakota, Alona J. Jarmin

Walden Dissertations and Doctoral Studies

In this quality improvement project, I assessed a telehealth-enhanced care coordination model in a rural primary care clinic to improve chronic disease management for adults with limited access to in-person services. The issues addressed included delayed follow-up, inconsistent self-management support, and limited continuity of care, which significantly affect rural populations and health equity. The purpose of this doctoral project was to evaluate whether a structured telehealth follow-up protocol improved key care coordination outcomes, appointment adherence, follow-up timeliness, and documentation completeness for rural adults receiving chronic disease management services. In this project, I employed a pre-/postimplementation evaluation design using de-identified electronic …

Experiences Of Care-Seeking Parents With Children With Autism Spectrum Disorder In India, Yash Navnit Patel

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) affects approximately 18 million individuals in India, yet the factors influencing parental care-seeking behavior were not well understood. Guided by the health belief model, the purpose of this basic qualitative study was to explore how parents’ perceived severity of a child’s symptoms, parental beliefs about the causes of autism, and perceived mental and physical health outcomes of caregiving influence parents’ intention to seek services for children aged 1–10 years diagnosed with ASD in India. Data were collected using semistructured interviews with 10 mothers of autistic children. Data were analyzed using Braun and Clarke’s six-step thematic analysis. …

Program Proposal For A Nurse Led Pre-Procedure Readiness Program, Walter Magramo

Walden Dissertations and Doctoral Studies

Same-day outpatient procedural cancellations represent a persistent challenge for healthcare organizations, negatively affecting patient safety, access, operational efficiency, and financial performance. This Doctor of Nursing Practice (DNP) executive leadership project proposes the implementation of a nurse-led, artificial intelligence (AI)–enhanced preprocedural readiness program within an outpatient procedural department. The initiative integrates standardized nurse-led readiness checklists, AI-supported clinical decision support embedded in the electronic health record, structured nurse-led outreach, and standardized patient and staff education to proactively identify and address preventable barriers to procedural readiness. Internal organizational data identified a sustained same-day cancellation rate of approximately 22%, with most cancellations attributable to …

Preventing Burnout In School-Based Behavioral Health Clinicians: Organizational Strategies For Mitigating Work-Related Mental Health Impairment, Virginia W. Lee

Walden Dissertations and Doctoral Studies

This is a qualitative case study on Organization X that used the Baldrige Framework to investigate employee burnout, a growing concern associated with staff turnover, reduced job satisfaction, depression, and disengagement. The goal was to examine how organizational leaders assess the effectiveness of burnout prevention strategies, identify organizational factors and leadership practices that either mitigate or increase burnout, and discover key factors that contribute to burnout. Semi-structured interviews, guided by the Baldrige Framework, were conducted with three leaders at Organization X. The themes resulting from interviews included burnout, open-ended communication, team cohesion, real-time protection, ethical leadership and authenticity, restoring norms, …

Mitigating Throughput Delays, Sherry Cabebe-Jacolbia

Walden Dissertations and Doctoral Studies

Throughput widely affects all healthcare organizations. The patient care quality gap centers on throughput because poor flow and boarding causes overcrowding, leading to adverse outcomes and mortality. The practice-focused question was: How can the hospital throughput be improved to help prevent adverse effects when boarding in the emergency room (ER) for a long period of time? This process improvement project was implemented by multidisciplinary teams who addressed barriers in patient flow in real-time. The implementation stage showed boarding time in August of 2025 of 4,275 minutes to October 2025 of 2,545 minutes. The throughput performance trending scorecard of the metrics …

Nurse-Led Educational Program For Standardized Discharge Coordination, Janet Foster

Walden Dissertations and Doctoral Studies

Fragmented discharge processes increase the risk of missed follow-up, medication nonadherence, and avoidable 30-day psychiatric readmissions among individuals with serious mental illness (SMI). I conducted this Doctor of Nursing Practice project to address this practice gap by developing a standardized nurse-led educational framework to strengthen discharge coordination in an inpatient psychiatric setting. The practice-focused question examined whether a standardized nurse-led discharge coordination education framework would improve discharge coordination for adults with SMI transitioning from inpatient to outpatient psychiatric care compared with current non-standardized practices. In a comprehensive literature search using the Johns Hopkins Model, I identified 15 peer-reviewed studies, including …

Staff Education To Implement Routine Use Of Hamilton Depression Rating Scale On The Identification And Severity Classification Of Adult Depression In Primary Care, Christencia Nkechi Obinna-Igbokwe

Walden Dissertations and Doctoral Studies

This Doctor of Nursing practice (DNP) project was a quality improvement initiative focused on staff education to standardize the workflow and documentation of the Hamilton depression rating scale (HAM-D). The goal was to enhance measurement-based care and mitigate inconsistencies in depression severity assessments that could potentially delay treatment modifications, follow-up planning, and safety decisions. The practice-focused inquiry examined whether a concise staff education program, in conjunction with a HAM-D clinical practice guideline, would enhance staff knowledge and preparedness to administer and document the HAM-D for routine severity monitoring in adults exhibiting depressive symptoms. Employing rapid-cycle plan–do–study–act (PDSA) methodologies, five members …

Staff Education On Motivational Interviewing And Culturally Responsive Education To Reduce No-Shows And Appointment Cancellations, Aisha Adigun

Walden Dissertations and Doctoral Studies

No-show and late appointment cancellations remain significant challenges in outpatient psychiatry clinics, negatively impacting continuity of care, clinic efficiency, and patient outcomes. Motivational interviewing (MI) and culturally responsive communication are evidence-based approaches that support patient engagement and understanding, yet they are not consistently incorporated into staff education related to appointment adherence. This project evaluates whether staff education on MI and culturally responsive communication increases staff knowledge and skills in educating patients about no-show and appointment cancellation policies and whether this education contributes to improved appointment attendance. A pre–post intervention design will be used in an outpatient psychiatry clinic. Clinical and …

Impact Of Incentive Policies On Mathematics And Science Teachers’ Retention In Guyana’S Rural Secondary Schools, Verna Adrian

Walden Dissertations and Doctoral Studies

Research on teacher retention in rural areas highlights persistent challenges, including geographic isolation, limited resources, and inadequate support. Studies have shown that financial incentives are critical for sustaining teacher retention, but a gap in the literature exists as to what specific non-financial challenges may also be important in influencing teachers’ long-term commitment. To address the social problem of teacher retention in rural secondary schools in Guyana, this study assessed the effectiveness of incentive policies in retaining teachers across four selected regions facing unique challenges. Data were collected through semi structured interviews and analyzed using thematic analysis. The purpose of this …

Community Reintegration Programs For Successful Reentry For Individuals Deemed Not Guilty By Reason Of Insanity, Joanna Baker

Walden Dissertations and Doctoral Studies

Very little research has been conducted on the institution of community reintegration programs for individuals deemed not guilty by reason of insanity (NGRI). In the United States, each state can determine the path for community reentry with the NGRI population. California has a strategic and supportive reentry program that requires services such as drug testing, individual therapy, and close monitoring. Other states, including North Carolina, do not have a reentry program in place for the NGRI population. No research exists comparing states with conditional release programs and states without these programs. Consistence in community reintegration programs among all states can …

Reasons For Digital Transformation Project Failures Based On U.S. Project Managers’ Lived Experiences, Susan D. Landes

Walden Dissertations and Doctoral Studies

Digital transformation projects have a failure rate of 66% to 84%, costing U.S. companies billions of dollars each year. Organizational leaders need to understand the implications of these costly failures, leading to substantial financial losses. The purpose of this qualitative descriptive phenomenological study was to explore the reasons for digital transformation project failures from the perspective of the lived experiences of U.S. project managers. The conceptual framework consisted of Lewin’s 3-stage change management model, Correani et al.’s digital transformation implementation model, Herzberg’s 2-factor theory of motivation-hygiene, and von Bertalanffy’s systems theory. The participants were 13 U.S. active, certified professional project …

Trauma Coping Mechanisms Among Police In Small Departments, Peter Michael Ungaro

Walden Dissertations and Doctoral Studies

Mental health services are available to police officers, but many do not utilize these resources due to stigma, shame, and fear of job loss. This reluctance often forces officers to handle mental health issues alone, frequently leading to unhealthy coping strategies that negatively impact their well-being and job performance. While advancements in mental health support exist, they primarily serve larger departments, leaving the needs of small departments largely unmet. The foundation of the study was rooted in resilience theory, which holds that the impact of trauma on an individual is determined not by the event itself but by the coping …

Emotion Regulation And Stress In Adult Learning Through Social Media Platforms, Jennifer Irocky

Walden Dissertations and Doctoral Studies

Social media platforms have become significant contexts for informal learning among adults, offering access to information and peer exchange outside of formal educational settings. These platforms are also emotionally complex environments in which stress and emotion regulation may shape learning outcomes. The purpose of this quantitative, nonexperimental study was to examine the relationship between social media use and informal learning in adults, with perceived stress and emotion regulation examined as moderating variables. Secondary data from the Stress in America: The State of Our Nation, 2007–2018 surveys were analyzed, using binary logistic regression with moderation while controlling for age, gender, and …

Multimodal Interventions To Assist In Reducing No Show Rates In An Outpatient Primary Care Setting, Amelia Barber

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) incorporated a Clinical Practice Guideline (CPG) approach to address a practice issue of increased no show rates of patients scheduled for follow-up appointments in an adult outpatient primary care setting. Missed appointments symbolize a long-standing practice problem in ambulatory care, exacerbating challenges like healthcare expenses, fragmented care, inefficient resource utilization, and delayed treatment often resulting in negative patient outcomes. The project’s purpose was to develop an evidence-based CPG with integrated multimodal patient outreach strategies, including patient portal, text messaging, transportation support, and live reminder calls within Electronic Health Record (EHR) system to prevent and/or …

Sepsis Bundle Compliance Initiative, Engleish Annette Flynn

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on the development and evaluation of a clinical practice guideline (CPG) designed to improve compliance with the Centers for Medicare & Medicaid Services (CMS) SEP-1 sepsis bundle at a 300-bed Level III trauma center serving a rural population in West Virginia. Sepsis remains a leading cause of morbidity and mortality nationwide, and rural hospitals face additional challenges related to delayed presentation, limited resources, and workflow variability. Inconsistent adherence to evidence-based sepsis bundle elements have been associated with increased mortality risk, prolonged length of stay, and financial penalties (Evans et al., 2021). The purpose …

Leadership Strategies To Promote Employee Engagement In Therapeutic Agencies, Paris Sim'mone Lewis

Walden Dissertations and Doctoral Studies

This study investigates the persistent decline in employee engagement among behavioral health clinicians working within community-based therapeutic agencies, focusing specifically on Behavioral Health Organization A (BHOA). The purpose of this qualitative study is to explore how leadership style, communication practices, and organizational structure affect clinician engagement at BHOA. Grounded in the Baldridge Performance Excellence Framework and supported by transformational leadership theory, the study examines how leadership behaviors and communication pipelines shape motivation, burnout, and workforce alignment. Semi-structured interviews with organizational leaders, secondary data, and internal documents were collected and analyzed using Braun and Clarke’s thematic analysis approach. Themes revealed communication …

The Importance Of Timely Documentation Of Updates On Patients’ Records In Improving Documentation Accuracy And Reducing Clinical Errors At The Home Health Agency, Sandra Aigbekaen

Walden Dissertations and Doctoral Studies

Timely and accurate documentation is essential to patient safety, care coordination, and risk reduction in home health care. In this Doctor of Nursing Practice project, I implemented an evidence-based educational intervention to improve documentation practices among clinicians at a pediatric home health agency in the southwest United States. Guided by the analyze, design, develop, implement, and evaluate (ADDIE) instructional design model, I conducted the project to evaluate whether focused education would improve documentation accuracy, consistency, and timeliness. A targeted literature review on electronic health record (EHR) best practices, structured documentation, and patient safety informed the development of five training modules …

Developing A Comprehensive Program Plan For Postpartum Mental Health Assessment And Follow-Up Care, Kimberly Osborne

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was an executive leadership proposal to develop an evidence-based program plan for standardized postpartum mental health screening and structured referral processes within an obstetric clinic. The practice problem was inconsistent postpartum mental health screening and follow up. Internal organizational data demonstrated elevated no-show and cancellation rates among obstetric patients referred for mental health services, reflecting gaps in care coordination, particularly for rural and underserved populations. The purpose of this project was to develop a comprehensive program plan guided by the following practice-focused question: Will a standardized postpartum mental health screening and structured referral program …

Development Of An Evidence-Based Educational Intervention Designed To Increase Staff Knowledge And Competence In Comprehensive Fall-Prevention Practices, Jacqueline U. Becerra

Walden Dissertations and Doctoral Studies

Inpatient falls continue to represent a significant nurse-sensitive quality indicator associated with patient injury, extended hospital stays, and increased healthcare costs. Despite the presence of established fall-prevention protocols, inconsistent completion of fall-risk assessments and uneven application of prevention strategies contributed to ongoing fall events at the project site. The practice problem addressed in this Doctor of Nursing Practice (DNP) project was the lack of consistent staff knowledge and application of evidence-based fall-prevention practices. The purpose of this evidence-based quality improvement project was to implement and evaluate a structured fall-prevention staff education program to increase inpatient staff knowledge related to fall-prevention …

Early Childhood Teachers’ Experiences Establishing Positive School-Home Relationships, Jayme Michelle Doyle

Walden Dissertations and Doctoral Studies

The problem in this study was that at Windland Elementary School (WES; pseudonym) early childhood teachers experienced a 16% decrease in parent satisfaction with the school's ability to eliminate or reduce barriers to parent engagement. Framed by six types of activities that encompass family engagement from Epstein et al., the purpose of this study was to explore early childhood teachers' experiences in establishing and maintaining school-home relationships at WES. Data were collected through semistructured interviews with 10 Kindergarten through Grade 3 teachers who had at least 3 years’ teaching experience at WES. Thematic analysis using open coding yielded four key …

Incarceration’S Impact On Young Adults’ Psychological Development, Well-Being, And Reintegration Into Society, Monica Murrell

Walden Dissertations and Doctoral Studies

This qualitative phenomenological study explored how individuals who experienced incarceration during emerging adulthood understood and made meaning of their developmental, emotional, and psychosocial experiences. Emerging adulthood, defined as ages seventeen through twenty-five, is a critical developmental stage, and incarceration during this period may disrupt identity formation and emotional maturation. The purpose of the study was to examine the perspectives and coping mechanisms of individuals incarcerated during this stage to better understand how early adult imprisonment shapes trauma responses, identity development, and reintegration. Social learning theory served as the conceptual framework. Data was collected through interviews with six formerly incarcerated adults …

Staff Education Project On Enhancing Provider Knowledge And Confidence In Adolescent Depression Assessment Using The Phq-9 Tool, Beatrice Ogoh Stephens

Walden Dissertations and Doctoral Studies

Adolescent depression is a developing public health issue, especially in underprivileged areas where delayed diagnosis and treatment are caused by uneven screening procedures and inadequate provider training. By increasing provider and staff knowledge, confidence, and use of the Patient Health Questionnaire-9 (PHQ-9) for systematic teen depression screening, this staff education project filled a practice gap in a primary care clinic. Fifteen clinic staff members who provide adolescent care participated in a four-hour evidence-based educational intervention that was guided by the ADDIE instructional design approach. Fifteen clinic staff members who provide adolescent care participated in a four-hour evidence-based educational intervention that …