Digital Commons Network^™

Staff Education To Use The Teach-Back Method Toward Increasing Adherence To Medications In A Mental Health Clinic, Yanysel Gonzalez Torres

Walden Dissertations and Doctoral Studies

A staff development project was conducted at a mental health clinic to improve medication adherence among patients. The intervention was an evidence-based presentation on the teach-back method for staff members to educate them about the importance of using the teach-back method for patient teaching to increase medication adherence among mental health patients. The gap identified by leadership was that staff members are often unaware of strategies for patient education designed to ensure that patients take their medications as prescribed by the provider. The project was conducted over a period of 4 weeks, with sessions held 3 days per week, taking …

The Role Of Leadership And Communication Training In Non-Profit Hospitals And The Influence On Leadership Change, Brian Pugliese

Walden Dissertations and Doctoral Studies

Non-profit healthcare organizations face ongoing challenges in aligning leadership competencies with the dynamic demands of the healthcare environment, with a significant gap persisting in formal leadership training and communication development for both emerging and established leaders. The purpose of this integrative review was to examine existing knowledge on healthcare leadership in non-profit hospitals and provide best practices in leadership communication to decrease leadership-gap in current and future leaders in non-profit hospitals. The review question focused on determining evidence-based strategies for enhancing communication training and leadership skill development among administrative leaders. Kotter’s 8-Step Process provided a framework for successful organizational change. …

Pharmacy Service Quality Strategies To Mitigate Prescription-Only Medicines Stockouts, Martin Mulomba

Walden Dissertations and Doctoral Studies

Some patients in Lusaka, Zambia experience adverse health outcomes when pharmacists are not able to fill life-saving, prescription-only medications (POMs) because of supply-chain shortages. Important to pharmacists are strategies to improve POMs supply and mitigate out-of-stock occurrences. Grounded in the SERVQUAL theory as the conceptual framework, the purpose of this qualitative multiple case study was to explore the service quality strategies pharmacists employ to mitigate shortages and enhance patient care. The participants were eight pharmacists who successfully mitigated POMs shortages for improved customer service. Data were collected using semistructured interviews and publicly available documents. Data were analyzed thematically and six …

Staff Education To Enhance Psychiatric Medication Adherence In Psychiatric Care, Emmanuel Nusta

Walden Dissertations and Doctoral Studies

Medication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play …

Promoting Equitable Early Childhood School Readiness Through Prevention And Advocacy In A Rural Community, Teri Kimberling

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The goal of this Social Change Portfolio is to promote healthier developmental outcomes for young children in our rural community by increasing access to early childhood readiness supports that prevent social-emotional and behavioral difficulties in kindergarten.

Significant Findings

Early childhood school readiness is a significant public health and mental health concern in the rural coastal community of Lincoln County, Oregon. A large number of children enter kindergarten without any school readiness, whether it was in a formal preschool or just done at home. This can be due to many factors, including socioeconomic disparities, such as high poverty rates, …

Staff Education To Emergency Nurses On Improving Handoff Communication Using The I-Pass Tool, Lekeyna Gleason

Walden Dissertations and Doctoral Studies

Effective communication during nurse-to-nurse handoff remains a critical determinant of patient safety in high-acuity emergency settings, where rapid decisions and fluctuating clinical demands can lead to inconsistent structure, omission of critical information, and inefficient transitions of care. The practice gap identified was a lack of standardized knowledge and consistent use of a structured bedside handoff tool among emergency department (ED) nurses. The practice-focused question guiding this project was, Does educating ED nurses on using the I-PASS bedside handoff tool improve knowledge of structured bedside reporting as measured by pre- and post-implementation surveys? The ADDIE framework and the Johns Hopkins evidence-based …

Staff Education For The Management Of Chronic Pain In Patients With Mental Health Disorders, Jude Osagie Ukpebor

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a practice-focused quality improvement staff education initiative designed to address a gap in nurses’ knowledge related to chronic pain management in patients with mental health disorders. Chronic pain frequently coexists with psychiatric conditions, yet nurses often lack formal education on biopsychosocial, trauma-informed, and non-pharmacologic pain management approaches, contributing to fragmented and inequitable care. Addressing this gap is essential to improving patient outcomes and advancing evidence-based nursing practice. The practice-focused question asked whether implementing a targeted nurse education program would improve nurses’ knowledge related to chronic pain management in patients with mental health disorders. …

Mental Health Professional Shortages In Washington State, Lanh Tran

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The social change portfolio aims to highlight the persistent shortage of mental health professionals in Washington State, the reasons behind this crisis, and to find sustainable solutions to reduce burnout.

Significant Findings

Washington State is experiencing a shortage of mental health professionals in the urban and rural areas. The most significant contributing factor is professionals' feeling burnt out. This happened before the pandemic, but it escalated significantly afterwards. Burnout is physical and emotional exhaustion coupled with self-doubt because of a psychological response for people in roles of caring and supporting others. In Washington State, there is 1 mental …

Digital Trust Recovery: Effective Data Breach Management Approaches, Milbert Flores Dacayana

Walden Dissertations and Doctoral Studies

In the digital economy, organizations face an increasing number of data breaches that compromise sensitive information and erode consumer trust. Some organizational leaders are concerned about the lack of effective strategies to manage data breaches and restore stakeholder confidence, which threatens organizations’ reputation and financial stability, and long-term trust in digital systems. Grounded in cybersecurity risk management theory (CRMT) and situational crisis communication theory (SCCT), the purpose of this qualitative pragmatic inquiry was to explore the strategies employed by data managers in Virginia, Maryland, and Washington, DC, to manage data breaches and rebuild consumer trust. Participants were 10 experienced data …

An Assessment Of New Employee Training In A U.S. Government Agency, Kisaana Fernanders

Walden Dissertations and Doctoral Studies

This study evaluated the utility of a newly developed employee training initiative within a U.S. government disaster recovery agency. The purpose of the professional administrative study was to examine the existing training architecture and recommend improvements aligned with the agency’s mission. A general qualitative approach was employed, using interviews and surveys with government personnel to elicit their perceptions of the training’s effectiveness. The research aimed to identify key elements to incorporate into a revised employee training program, with the goal of enhancing disaster response readiness and policy implementation. It also sought to recommend strategies for continuous improvement. The study was …

Implementation Of Structured Nursing Leadership Rounding To Improve Hospital Policy Adherence, Irma Rose Maize

Walden Dissertations and Doctoral Studies

Variability in nursing policy compliance contributes to inconsistent clinical practice and compromises the delivery of standardized care. Limited leadership presence, support, and accountability have been identified as significant contributors to this practice gap. This Doctor of Nursing Practice project focused on educating nurse leaders about the importance and benefits of consistent unit-based leadership rounding as a strategy to support frontline nurses and reinforce policy adherence. A structured leadership rounding checklist was developed to guide purposeful, consistent check-ins with nursing staff, facilitating real-time support and identification of barriers to practice. Implementation of the checklist promoted increased leadership accessibility, improved communication, and …

Staff Education To Increase Knowledge And Awareness Of Cultural Sensitivity Among Providers, Stephanie Chiamaka Anyanwu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project aimed to enhance cultural sensitivity among healthcare providers through an educational intervention in a local organization. With the U.S. foreign-born population exceeding 47 million, the need for culturally competent care has become paramount. The study involved nine participants who underwent a pretest and posttest assessment to evaluate their knowledge and awareness of cultural sensitivity. Results indicated a significant increase in knowledge, with pretest and posttest scores improving from a mean of 4.33 to 8.56 (p < 0.01). Awareness in key areas such as patient-provider relationships, cultural beliefs, and language barriers also showed marked improvement. These findings further support the necessity of ongoing cultural sensitivity training to enhance patient care and outcomes, highlighting the potential for broader application across healthcare institutions.

Self-Stigma Of Seeking Help, Psychological Safety, And Employee Assistance Program Use In Nurses, Latisha Lenee Marshall

Walden Dissertations and Doctoral Studies

Employee assistance programs (EAPs) remain underutilized across various U.S. work sectors, including nursing. There are several barriers that impede nurses from using EAP services, including self-stigma of seeking help (SSOSH) and psychological safety (PS). The purposes of this study, which used the health promotion model as its theoretical framework, were to determine (a) if there was a difference in the level of SSOSH in nurses who have used EAPs and those who have not used EAPs, (b) if there was a difference in the level of PS in nurses who have used EAPs and nurses who have not used EAPs, …

Staff Education To Improve Nurses' Knowledge And Confidence In Suicide Risk Assessment, Sherica Mcbride

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice staff education project was to strengthen nurses’ knowledge and confidence in suicide risk assessments. Suicide remains a crucial patient safety issue, and nurses report uncertainty in early recognition and intervention; therefore, brief, practice-proximal training is essential. The practice-focused question that informed this project’s purpose was whether a short education module with pre- and post testing improves nurses’ knowledge and confidence in suicide risk assessment. Three nurses participated in a structured session covering risk factors, warning signs, standardized screening, and safety planning. I then used descriptive analysis to compare their pre- and posttest …

Predicting Perceived Immigrant Threat To National Identity Based On Christian Nationalism, White Racial Centrality, And Social Dominance Orientation, Anna Caroline Kinney

Walden Dissertations and Doctoral Studies

Immigrants remain frequent targets of anti-immigrant hate speech, often amplified by right-wing media. Demographic factors such as Christian nationalism (i.e., the desire to preserve Christian symbols, beliefs, and policies preserved as the established religion of the United States), White racial centrality (i.e., an automatic association between the self and the White ingroup), and social dominance orientation (i.e., support for group-based hierarchies and inequality) significantly shape perceptions of immigrants as a threat to national identity. Although prior research has examined these factors independently, their relative importance in predicting perceived immigrant threat remains limited. Informed by intergroup threat theory, this quantitative study …

Staff Education On Metabolic Syndrome Screening In Patients Receiving Long-Acting Injectable Psychotropics, Efetze Metangpa Akana

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was a staff education initiative designed to improve metabolic syndrome screening practices for patients receiving long-acting injectable psychotropic medications in an outpatient psychiatric setting. People living with serious mental illness face a heightened risk of cardiometabolic conditions, and inconsistent screening leads to delayed detection, avoidable illness, and ongoing health disparities, underscoring the importance of this practice gap within nursing practice due to nurses’ central role in medication oversight and preventive care. A key limitation of the project was the small sample size and short-term evaluation period, which limited generalizability and did not allow …

Reflective Parenting, Psychological Needs, And Parental Interpretation Of Children’S Negative Emotions, Julia Pappas

Walden Dissertations and Doctoral Studies

Parents’ ability to understand and respond effectively to children’s negative emotions plays a critical role in children’s emotional development and regulation. However, it remains unclear whether parents interpret negative emotions as potential signals of underlying psychological needs. Based in the conceptual framework of parental reflective functioning and basic psychological needs theory, and grounded in interpretivist- constructivist paradigm, the purpose of this basic qualitative study was to examine how parents interpret children’s negative emotions and how their meaning-making processes relate to basic psychological needs. Semistructured interviews were conducted with parents of children between ages 3 and 9 years old (N = …

Strategies Leaders In Structured Alternative Academic Environments Use To Improve Resource Management, Operational Efficiency, And Program Sustainability, Sean D. Clark

Walden Dissertations and Doctoral Studies

Leaders of structured alternative academic environments often struggle to sustain operations because of limited resources, fragmented leadership, and high staff turnover. This business problem is important to leaders of structured alternative academic environments because ineffective resource management and operational inefficiencies threaten program sustainability and continuity of services for at-risk student populations. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry was to explore the strategies leaders in structured alternative academic environments use to improve resource management, operational efficiency, and program sustainability. The participants were six leaders from structured alternative academic programs in southeastern New Mexico. Data were …

Leadership Strategies Used By Entrepreneurial Ecosystem Resource Providers To Support Entrepreneurial Success, Sarah Niehaus

Walden Dissertations and Doctoral Studies

Failure to collaborate effectively within entrepreneurial ecosystems remains a significant concern for leaders of entrepreneurial ecosystem organizations. Without clear, actionable collaboration strategies, these leaders may struggle to support entrepreneurial success and make informed decisions that enhance financial performance. Grounded in Mockler’s complex adaptive systems theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies some leaders within entrepreneurial ecosystem organizations use to collaborate in a manner that supports entrepreneurial success. Participants included seven leaders of entrepreneurial ecosystem organizations located in the Midwest United States with successful experiences using such strategies. Data were collected from semistructured …

Educational Design Models In Transition: A Comparative Review, Tofan Stofiana, Yeti Mulyati, Andoyo Sastromihardjo, Dadang Sunendar

Journal of Educational Research and Practice

A persistent gap between educational theory and classroom practice underscores the need for methodological approaches that are reflective, participatory, and context responsive. This study provides a comparative review of four major educational design models, including research and development (R&D); Analysis, Design, Development, Implementation, and Evaluation (ADDIE); design-based research (DBR); and educational design research (EDR), to examine their theoretical orientations and contemporary applications. A systematic literature synthesis and bibliometric mapping were conducted on 80 peer-reviewed journal articles indexed in Scopus between 2020 and 2025. The findings reveal that ADDIE remains the most frequently applied framework due to its procedural clarity and …

Prevention And Resilience: Addressing Thc Use In Little Elm, Denton County, Texas, Luci Papanastassiou

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The goal of this Social Change Portfolio is to design a collaborative, community-level primary prevention program for adolescents in the Little Elm, Denton County, Texas area to mitigate the mental health and cognitive risks associated with THC use while strengthening protective factors across the entire community (County Health Rankings & Roadmaps, 2018; Smith, 2024; Substance Abuse and Mental Health Services Administration, 2025).

Significant Findings

The Little Elm, Denton County, Texas area is an area of growth and development that also faces the need for mental health professionals, especially with the current situation of THC use with adolescents (Substance …

Atherogenic Index Of Plasma’S Association With Coronary Heart Disease Risks Among Postmenopausal Pakistani Women, Amad Khan, Syed Kashif Raza

Journal of Social, Behavioral, and Health Sciences

Coronary heart disease (CHD) is a leading global cause of mortality, notably affecting postmenopausal women. Hormonal fluctuations during menopause contribute to dyslipidemia, fostering cardiovascular disease (CVD). This study explored lipid profiles among postmenopausal Pakistani women, focusing on the atherogenic index of plasma (AIP) and its association with CHD.

The data consisted of surveys from 265 women aged between 40–70 years. A STEP-wise approach, using a questionnaire from the World Health Organization, was employed for data collection. This quantitative cross-sectional study, guided by the socioecological model, examined links between AIP, age, lipid profiles, and hypertension. The AIP’s association with CHD was …

Strategies To Reduce The Physician Documentation Burden In Adult Primary Care, Glenda Cascalla

Walden Dissertations and Doctoral Studies

Primary care physicians face high rates of burnout, with electronic health record (EHR) documentation identified ass a significant contributing factor. EHR systems consume substantial physician time, diverting attention from meaningful patient interactions toward administrative tasks and increasing documentation burden. The purpose of this study is to identify and evaluate best practices for minimizing the documentation burden on primary care providers. The review question centered on how best practices can be implemented by healthcare administrators to reduce the physician documentation burden in primary care. This integrative review used the sociotechnical systems theory framework to identify and evaluate effective strategies to alleviate …

Community And Individual Risk Factors Associated With Tuberculosis Treatment Outcomes: Ca, Md, And Oh, [2017-2021]., Kadiatu Banjoko

Walden Dissertations and Doctoral Studies

There are unsuccessful treatment outcomes with Tuberculosis (TB) disease, although effective therapies exist. This study aimed to identify predictors of unsuccessful treatment using the socioecological model. A quantitative cross-sectional study and multinomial logistic regression analysis were used to measure the associations between long-term care (LTC), homelessness, correctional facility, Human Immunodeficiency Virus (HIV), diabetes, excess alcohol, illicit drug use, and TB treatment outcomes of death, lost to follow-up, and treatment refusal. The sample consisted of 7,589 individuals aged 15 and older with pulmonary TB between 2017 and 2021, residing in California, Ohio, and Maryland. Findings indicated a correlation between community factors …

The Lived Experience Of Gay Men In The Generation Jones Cohort, Thomas Stacy Helton

Walden Dissertations and Doctoral Studies

Existing research lacks examination of the interplay between life histories and gay identities within the Generation Jones cohort, hindering our understanding of how individuals navigated the challenges of aging Specifically, we lack understanding of how identity formation, stigma, and historical trauma in light of sociocultural events—including the criminalization of homosexuality, the HIV/AIDS epidemic, and the rise of digital connectivity—shaped self-concept, relationships, and resilience. This qualitative phenomenological study explored the lived experiences of gay men in the Generation Jones cohort, defined as those born between 1954 and 1965. Grounded in social identity theory, it asked how gay men in this cohort …

Strategies Financial Institutions Use To Mitigate Security Breaches For Mobile Customers, Steven F. Knese

Walden Dissertations and Doctoral Studies

Mobile fraud attack rates are increasing rapidly. Financial institutions, cybersecurity managers, and regulators need effective strategies to reduce consumer financial harm and operational risk. Grounded in the cybernetics model, this qualitative, pragmatic inquiry identified the cybersecurity strategies that cybersecurity professionals use at financial institutions to mitigate data breaches for mobile customers accessing financial data. Data were collected from five cybersecurity professionals through semistructured interviews and from publicly available documents and guidance issued by financial institutions and standards bodies. Six significant themes emerged from thematic analysis: implementing multifactor authentication, deploying virtual private networks (VPNs), delivering user education, promoting regular account monitoring, …

Polypharmacy In The Geriatric Population, Colleen Laflamme

Walden Dissertations and Doctoral Studies

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

Paternal Filicide In The Context Of Divorce And Child Custody, Andrea Chase

Walden Dissertations and Doctoral Studies

This qualitative study examined the troubling intersection of parental separation, domestic violence and paternal filicide, issues that profoundly challenge societal and legal frameworks. Although domestic violence and marital dissolution are recognized risk factors for child maltreatment, their role in paternal filicide, specifically when motivated by parental separation, has been understudied. Using a purposeful and criterion-based sampling strategy, cases were drawn from the Center for Judicial Excellence database of children murdered during divorce, parental separation, and child custody disputes. After applying predefined inclusion and exclusion criteria, the final sample consisted of 113 biological fathers responsible for the deaths of 263 children …

Implementing Emotional Intelligence To Enhance Leadership Abilities In A Skilled Nursing Home, Nkechi Amaechina

Walden Dissertations and Doctoral Studies

To meet dynamic changes in healthcare, effective leadership is necessary. A major problem with effective leadership is the lack of emotional intelligence (EI). The purpose of this integrative review is to identify strategies that enhance skilled nursing home leadership abilities using EI. The Leader-Member Exchange (LMX) theory was used, supported by Complex Adaptive Systems (CAS)Theory. LMX theory explains that leaders-members relationships affect an organization while CAS theory describes healthcare industry as ever-changing. The review question (RQ) that guided this integrative review is: what best EI strategies can be implemented to enhance leadership abilities in a skilled nursing home? Twenty-six articles …

Teaching Staff About Pressure Ulcers, Ann Maria Stewart

Walden Dissertations and Doctoral Studies

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