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Articles 211 - 240 of 16767
Full-Text Articles in Entire DC Network
Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger
Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger
Walden Dissertations and Doctoral Studies
Social determinants of health (SDOH) significantly influence health outcomes, yet many primary care organizations lack a standardized, evidence-based process for identifying patients' social needs and facilitating referrals to appropriate community resources. The purpose of this Doctor of Nursing Practice executive leadership project was to develop and implement a clinical practice guideline (CPG) to standardize SDOH screening and social services referrals in a primary care setting. The practice-focused question asked whether a CPG designed to standardize social services referrals would be approved by a panel of subject matter experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. …
Staff Education To Improve Evidence-Based Follow-Up For Patients With Severe Depression In An Outpatient Mental Health Clinic, Uzochiamaka Ndukwu
Staff Education To Improve Evidence-Based Follow-Up For Patients With Severe Depression In An Outpatient Mental Health Clinic, Uzochiamaka Ndukwu
Walden Dissertations and Doctoral Studies
The practice gap addressed in this Doctor of Nursing Practice (DNP) staff education project was the inconsistent documentation completion of evidence-based depression follow-up actions for patients with severe depression in an outpatient mental health clinic. National clinical practice guidelines recommend that patients with clinically significant depression receive timely, documented follow-up that includes appropriate treatment planning, behavioral health follow-up, medication management when clinically indicated, and repeat symptom reassessment. However, baseline chart audit findings demonstrated variability in documentation of these evidence-based follow-up actions. The practice-focused question was: In an outpatient mental health clinic, does a standardized staff education program on evidence-based depression …
Exploring Licensed Clinical Social Workers’ Past Trauma And Current Practice: A Strengths-Based Perspective, Michael E. Conner
Exploring Licensed Clinical Social Workers’ Past Trauma And Current Practice: A Strengths-Based Perspective, Michael E. Conner
Walden Dissertations and Doctoral Studies
This qualitative study explored the lived experiences of licensed clinical social workers to examine how they manage, reinterpret, and integrate their childhood trauma into their professional clinical identities. Adverse childhood experiences among clinicians are often framed through a risk-based lens of burnout and impairment, leaving social work leaders without empirical models to support post-traumatic growth and workforce retention. The purpose of this study was to examine how clinicians leverage past adversity to inform contemporary practice. A basic qualitative design was used, with semistructured interviews conducted with 11 participants. Participant narratives were examined through the dual lenses of shattered assumptions theory …
Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood
Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood
Walden Dissertations and Doctoral Studies
The healthy immigrant effect (HIE) is an observed phenomenon in which immigrants exhibit better health outcomes than native-born residents, though relatively few studies have examined its role in chronic diseases in the United States. The purpose of this quantitative cross-sectional study was to assess the associations between immigration status, age, sex, race/ethnicity, median household income, and geographic location and lung cancer diagnosis in first-generation immigrant adults aged 18 or older. The subsequent health trajectory model provided the theoretical framework for the study. Data were obtained from the SEER*Stat Database 1975-2022 (N = 1,993). Binomial regression analysis showed that immigrants were …
Reducing Urinary Tract Infections In Long-Term Care Residents, Felicity Antwi
Reducing Urinary Tract Infections In Long-Term Care Residents, Felicity Antwi
Walden Dissertations and Doctoral Studies
This quality improvement (QI) project addressed delays in diagnosing urinary tract infections (UTIs) at a skilled nursing facility (SNF), where reliance on urine culture testing and patient monitoring resulted in an average diagnostic period of 72 hours. A high UTI incidence and UTI-involved hospitalization rate are both nurse-sensitive indicators that are important to address in the nursing practice context because they portend negatively for nursing quality and safety. This quality improvement (QI) project addressed the practice-focused question: among long term care (LTC) residents with suspected UTIs in a nursing home (NH), how does reducing the diagnostic period from 72 hours …
Leveraging Innovation And Resilience: A Qualitative Project Of Mid-Level Managers Driving Business Performance In Multinational Corporations, Karla Karey Diaz
Leveraging Innovation And Resilience: A Qualitative Project Of Mid-Level Managers Driving Business Performance In Multinational Corporations, Karla Karey Diaz
Walden Dissertations and Doctoral Studies
Employee underdevelopment in multinational corporations (MNCs) can weaken the organization’s agility and competitive advantage in the global market. Mid-level managers must be leveraged effectively, as this level of management holds primary adaptive responsibility for building, integrating, and reconfiguring resources during organizational change. Grounded in the dynamic capabilities theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies mid-level managers in MNCs use to improve dynamic capabilities. Participants were 10 U.S.-based MNC mid-level managers with experience using strategies to improve dynamic capabilities. Data were collected through semistructured interviews and publicly available documents, including strategic plans, …
Parents' Perspectives Of Factors Contributing To Speech Delays In Children Born During The Covid-19 Pandemic, Alva Jessica Daniels
Parents' Perspectives Of Factors Contributing To Speech Delays In Children Born During The Covid-19 Pandemic, Alva Jessica Daniels
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic significantly disrupted children’s developmental environments by limiting access to childcare, healthcare, and opportunities for social interaction, raising concerns about speech and language outcomes in children born during this period. Grounded in Bronfenbrenner’s ecological systems theory, this qualitative study was an exploration of factors associated with speech and language delays and examined parents’ perceptions and experiences in Philadelphia. The qualitative study included a sample of nine parents who cared for children during the COVID-19 pandemic quarantine period. Analysis of the interview data revealed five emergent themes: (a) limited social interaction during the pandemic, (b) delayed identification and diagnosis …
Staff Education To Improve Staff Knowledge, Confidence, And Competency In The Use Of The Zung Self-Rating Depression Scale, Theresa Buabeng
Staff Education To Improve Staff Knowledge, Confidence, And Competency In The Use Of The Zung Self-Rating Depression Scale, Theresa Buabeng
Walden Dissertations and Doctoral Studies
Staff Education to Improve Staff Knowledge, Confidence, and Competency in the Use of the Zung Self-Rating Depression Scale
English As A Second Language Students’ Perceptions On Their Reasons To Persist In An Adult Learning Program In Connecticut, Laurie Anne Winek
English As A Second Language Students’ Perceptions On Their Reasons To Persist In An Adult Learning Program In Connecticut, Laurie Anne Winek
Walden Dissertations and Doctoral Studies
The problem that was addressed through this study is that 30% of the English as a second language (ESL) students drop out of classes after the first 2 weeks in an adult education program in Connecticut. Grounded in Tinto’s model of student departure, the purpose of this study was to explore ESL students’ perceptions on reasons they persisted in an adult education program in Connecticut. For this basic qualitative design, semistructured interviews were conducted with five students. The data analysis procedures used open coding and categories, with eight themes emerging: ESL students persisted when their instructors cultivated lifelong learning; included …
Improving Medication Adherence Through Structured Telephone Follow-Up To Reduce 30-Day Readmissions Among Adult Patients With Heart Failure, Angela Dean Hamilton
Improving Medication Adherence Through Structured Telephone Follow-Up To Reduce 30-Day Readmissions Among Adult Patients With Heart Failure, Angela Dean Hamilton
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) evidence-based quality improvement (QI) project addressed high 30-day hospital readmission rates among adults with heart failure (HF), a problem associated with poor medication adherence and inadequate transitional care that nurses are uniquely positioned to address through discharge education, medication reconciliation, and postdischarge follow up to improve patient safety and quality of care. The practice-focused question asked: In adult patients discharged with HF, how does a structured, nurse-led, telephone follow-up intervention focused on medication adherence, compared with usual discharge care, affect 30-day hospital readmission rates over a 90-day implementation period? The purpose of this DNP …
Cultural Integration Of Ethiopian Immigrants And Refugees And Role Of Ethnic Nonprofits In Chicago, Aklilu Abraham Adeye
Cultural Integration Of Ethiopian Immigrants And Refugees And Role Of Ethnic Nonprofits In Chicago, Aklilu Abraham Adeye
Walden Dissertations and Doctoral Studies
Despite the availability of institutional services and interventions, cultural integration outcomes among refugees and immigrants often remain uneven. Existing literature has demonstrated the important role of nonprofit organizations in supporting refugee and immigrant resettlement and early integration. However, comparatively little research has examined how refugees and immigrants themselves experience the influence of nonprofit services on long-term cultural integration. The purpose of this general qualitative study was to explore how nonprofit services and programs influence the cultural integration experiences of Ethiopian refugees and immigrants in Chicago through the lens of the new assimilation theory and the integration context perspective. Data were …
Effective Strategies Small Business Owners Use To Sustain Their Businesses During Periods Of Disruption, Tracey Starr Moon
Effective Strategies Small Business Owners Use To Sustain Their Businesses During Periods Of Disruption, Tracey Starr Moon
Walden Dissertations and Doctoral Studies
Small businesses experience significant challenges sustaining operations during periods of disruption, including economic uncertainty, natural disasters, supply chain interruptions, and other environmental changes. This is a concern for small business owners because disruptions can reduce revenue and strain limited financial and operational resources, putting their continued survival at risk. Grounded in the resilience theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies small business owners use to sustain their businesses during times of disruption. The participants were six small business owners in the southern United States. Data were collected through semistructured interviews and …
Implementing Routine Trauma Screening Using The Ace Questionnaire And Pcl-5, Esther Amune
Implementing Routine Trauma Screening Using The Ace Questionnaire And Pcl-5, Esther Amune
Walden Dissertations and Doctoral Studies
This evaluation of a quality improvement initiative addressed inconsistent trauma screening and electronic documentation at an outpatient site. The baseline trauma-screening completion rate was 60%, below the organization's 80% target. The gap was relevant to nursing because nurses support screening, documentation, referral, coordination, and follow-up. The practice-focused question addressed whether the Adverse Childhood Experiences (ACE) Questionnaire and the Posttraumatic Stress Disorder Checklist for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or PCL-5, would improve documented screening completion and trauma-informed treatment planning over 10 weeks. The purpose was to incorporate both tools into care and …
Staff Education To Improve Skills In Detecting And Addressing Medication Nonadherence Among The Psychiatric Nursing Staff, Uchenna Owunna
Staff Education To Improve Skills In Detecting And Addressing Medication Nonadherence Among The Psychiatric Nursing Staff, Uchenna Owunna
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project was a staff education project focused on addressing the knowledge gap of medication nonadherence patterns by the psychiatric nurses in outpatient settings. Nonadherence to psychiatric medications is a major health issue that leads to disruptions of care and symptom relapse, hospitalization, and suboptimal treatment outcomes as well as high healthcare costs. Thus, improving the capacity of the psychiatric nurses to enhance medication adherence through staff education is essential. The purpose of this DNP project was to determine if a comprehensive medication adherence education program would increase psychiatric nurses’ knowledge and skills in assessing …
Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes
Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes
Walden Dissertations and Doctoral Studies
Perceptions of safety and emotional support during involvement with child protective services (CPS) during adolescence may play a significant role in shaping attachment experiences and relationships in adulthood. Although researchers have examined the effects of child maltreatment and foster care involvement, limited research has explored how adolescents perceive emotional support and safety during CPS involvement and how those experiences influence attachment in adulthood. The purpose of this qualitative study was to explore the lived experiences of adults who experienced CPS involvement during adolescence and to understand how perceptions of safety and emotional support are reflected in their adult attachment relationships. …
Exploring The Experiences Of Nigerian Army Personnel With Toxic Leadership, Shamsideen Toyin Shafaru
Exploring The Experiences Of Nigerian Army Personnel With Toxic Leadership, Shamsideen Toyin Shafaru
Walden Dissertations and Doctoral Studies
Toxic leadership has been shown to be present in Nigeria, promoting negative consequences for organizations and adverse effects on employee performance. However, how toxic leadership behaviors impact Nigerian Army operations and the performance of personnel have not been studied. Exploring toxic leadership in the Nigerian Army is important because the way in which leaders exercise influence determines the effects it has on followers. The purpose of this general qualitative study was to examine the lived experiences of Nigerian Army personnel who had worked as subordinates of individuals who exhibited toxic leadership traits and its impact on their performance. The theoretical …
The Lived Experiences Of Midlife Black Women In Atlanta Managing Hypertension Through Nonpharmacological Interventions, Beth Feagins
The Lived Experiences Of Midlife Black Women In Atlanta Managing Hypertension Through Nonpharmacological Interventions, Beth Feagins
Walden Dissertations and Doctoral Studies
In this qualitative phenomenological study, the beliefs and lived experiences of midlife, low-income Black women with hypertension were explored, concentrating on understanding how social determinants of health influence effects adherence to diet, physical activity and stress management. Social determinants of health and how health beliefs shape adherence to behaviors were examined. The study was guided by a dual theory approach of the social cognitive theory and theory of planned behavior. Six women, identified as Black, between the ages 40-60, diagnosed with hypertension and living in Atlanta, Georgia, participated in the study. Data was analyzed using Moustakas’ phenomenological analysis and revealed …
Implementation Of A Standardized Columbia-Suicide Severity Rating Scale Screening Process In An Outpatient Psychiatric Practice, Dela Mensah Frimpong
Implementation Of A Standardized Columbia-Suicide Severity Rating Scale Screening Process In An Outpatient Psychiatric Practice, Dela Mensah Frimpong
Walden Dissertations and Doctoral Studies
This doctoral project was an organizational change initiative designed to implement a standardized suicide risk screening process in an outpatient psychiatric practice. The identified practice problem was inconsistent staff use and documentation of suicide risk screening, which could result in missed warning signs, delayed provider notification, incomplete documentation, and inconsistent follow-up care. Suicide risk identification is an essential nursing responsibility and a key component of patient safety (The Joint Commission, 2024; Zero Suicide, n.d.). The practice-focused question examined whether staff education and implementation of a standardized Columbia-Suicide Severity Rating Scale (C-SSRS) workflow would improve staff compliance, documentation completion, and knowledge …
Staff Education To Improve Clinical Staff Knowledge, Confidence, And Use Of The Patient Health Questionnaire-9 (Phq-9) In Outpatient Depression Screening, Madjou Stella Ngantche
Staff Education To Improve Clinical Staff Knowledge, Confidence, And Use Of The Patient Health Questionnaire-9 (Phq-9) In Outpatient Depression Screening, Madjou Stella Ngantche
Walden Dissertations and Doctoral Studies
Depression is one of the most common mental health conditions encountered in outpatient practice, yet inconsistent use of standardized screening tools contributes to missed opportunities for early identification and intervention. In outpatient settings, nurses and other clinical staff are often responsible for administering depression screenings; however, many lack formal education on the standardized use of the Patient Health Questionnaire-9 (PHQ-9). To address this practice gap, this Doctor of Nursing Practice (DNP) staff education project was implemented in an outpatient setting to determine whether staff education on the use of the PHQ-9 would improve staff knowledge, confidence, and intent to use …
Staff Education On Medication Nonadherence In Primary Care Clinic, Priscillia Adaugo Obasi
Staff Education On Medication Nonadherence In Primary Care Clinic, Priscillia Adaugo Obasi
Walden Dissertations and Doctoral Studies
This doctor of nursing practice (DNP) project was a staff education initiative designed to address the practice problem of a lack of evidence-based approaches to patient education on medication compliance in a primary care clinic. A literature search was conducted using PubMed, CINAHL, MEDLINE, and the Cochrane Library search engines/databases, revealing nine studies that supported the premise that patient education can promote medication compliance. A practice-focused question underpinning this project was: Will staff education on evidence-based methods for educating patients about the importance of medication adherence result in increased staff knowledge? Baseline staff knowledge and educational needs were obtained using …
Impact Of Emerging Technologies On Leadership Identity Of Behavioral Health Leaders, Jenah Habermehl
Impact Of Emerging Technologies On Leadership Identity Of Behavioral Health Leaders, Jenah Habermehl
Walden Dissertations and Doctoral Studies
Emerging technologies are reshaping behavioral health leadership by changing documentation, communication, ethical responsibilities, and role expectations. Qualitative case study research methodology was used in this study. The problem addressed in this case study was the limited understanding of how emerging technologies influence the leadership identity and professional values of behavioral health leaders. The Baldrige Performance Excellence Framework guided this study of behavioral health leaders at a privately operated behavioral health organization in the South Atlantic region of the United States. Data were collected by conducting semistructured interviews with four behavioral health leaders at the organization and gathering internal archival and …
Improving Pcu Nurses’ Knowledge Of Evidence-Based Mindfulness Techniques Through Targeted Education, Dairia Moore Mohammed
Improving Pcu Nurses’ Knowledge Of Evidence-Based Mindfulness Techniques Through Targeted Education, Dairia Moore Mohammed
Walden Dissertations and Doctoral Studies
The progressive care unit (PCU) is a high-acuity setting in which nurses manage patients with complex health conditions, respond to rapid changes in clinical status, and navigate ongoing physical and emotional demands. The practice problem that I addressed was, presently, stress-management support is typically informal, optional, and reactive rather than systematic, evidence-based, and preventive. The purpose of this project was to implement and evaluate a structured educational intervention designed to increase nurses’ knowledge of evidence-based mindfulness breathing techniques that could be integrated into the daily PCU workflow. The practice-focused question was: In PCU nurses in an acute care setting, how …
Workforce Solutions For Primary Care Physician Shortages In Veterans Health Administration Outpatient Clinics, Quintin Warner
Workforce Solutions For Primary Care Physician Shortages In Veterans Health Administration Outpatient Clinics, Quintin Warner
Walden Dissertations and Doctoral Studies
The shortage of primary care physicians (PCPs) in the Veterans Health Administration (VHA) hospital system highlights the need for strategies to effectively mitigate this issue. The purpose of this integrative review was to examine the literature on primary care physician shortages in VHA hospital-based outpatient clinics and determine evidence-based solutions. The review question centered on strategies and best practices that can be implemented to address PCP shortages in VHA outpatient clinics. The Donabedian Model provided the framework for analyzing structural factors, processes, and patient outcomes. A comprehensive review of the literature resulted in 40 articles being screened for quality and …
Sidama Women's Perceptions Of Female Genital Mutilation/Cutting And Marital Fidelity, Mekonnen Doyamo
Sidama Women's Perceptions Of Female Genital Mutilation/Cutting And Marital Fidelity, Mekonnen Doyamo
Walden Dissertations and Doctoral Studies
Female Genital Mutilation/Cutting (FGM/C) affects women from the Sidama region of Ethiopia differently from women in other parts of Ethiopia, which results in different physical and psychological consequences. The purpose of this qualitative case study was to explore why the Sidama people’s FGM/C custom differs from that of other parts of Ethiopia. A case study methodology was used to answer the following research question: How does the practice of FGM/C among the Sidama people in Ethiopia differ from that in other regions regarding its cultural significance and rituals? Moreover, how do community attitudes and beliefs surrounding FGM/C among the Sidama …
Strategies Human Resource Leaders Use To Implement Holistic Wellness Programs To Reduce Absenteeism And Increase Profitability, Diane Hardy
Walden Dissertations and Doctoral Studies
Human resources (HR) leaders struggle to reduce employee absenteeism and increase organizational profitability due to a lack of effective strategies for implementing holistic wellness programs. Identifying effective strategies for implementing holistic wellness programs is essential for helping HR leaders address absenteeism and strengthen organizational profitability. Grounded in the Pender health promotion model, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies for implementing holistic wellness programs to reduce employee absenteeism and increase organizational profitability. Participants were nine HR leaders from medium- to large-sized organizations across the United States who implemented holistic wellness programs to reduce …
Implementation Of An Electronic Gad-7 Screening Tool To Improve Anxiety Screening Completion And Documentation, Obiageli L. Ukatu
Implementation Of An Electronic Gad-7 Screening Tool To Improve Anxiety Screening Completion And Documentation, Obiageli L. Ukatu
Walden Dissertations and Doctoral Studies
Quality Improvement Initiative Implementation of an Electronic GAD-7 Screening Tool to Improve Anxiety Screening Completion and Documentation
Probation Officers’ Experiences Supervising Domestic And Intimate Partner Violent Probationers, Megan Davis
Probation Officers’ Experiences Supervising Domestic And Intimate Partner Violent Probationers, Megan Davis
Walden Dissertations and Doctoral Studies
This study includes insights regarding potential supervision challenges that are faced by probation officers overseeing domestic and intimate partner violence (IPV) probationers, emphasizing the importance of effective management to enhance offender accountability and victim safety. The relationship dynamic between probation officers and domestic and IPV probationers influences recidivism rates, highlighting the importance of effective and empathetic supervision. The purpose of this study was to identify gaps in training, supervision strategies, and resources, with a focus on integrating attachment-based practices to improve outcomes. Guided by the attachment theory, the research included key questions about supervision effectiveness and relational dynamics. Employing a …
Implementation Of A Fall-Prevention Clinical Practice Guideline In A Neurological Rehabilitation Center, Ron L. Adolph
Implementation Of A Fall-Prevention Clinical Practice Guideline In A Neurological Rehabilitation Center, Ron L. Adolph
Walden Dissertations and Doctoral Studies
This executive summary presents the final plan for implementation of an evidence-based fall-prevention clinical practice guideline on an open neurological rehabilitation unit. It does not propose a new device, a new electronic platform, or a separate education-only initiative. The practice change is the implementation and evaluation of a structured interdisciplinary clinical practice guideline designed to reduce inpatient falls and improve the reliability of daily prevention practices. The unit reports a baseline fall rate of 6.3 falls per 1,000 patient days. Thirty-five staff members from nursing, therapy, and support roles completed the survey, and 57% reported that patients had experienced falls …
Lived Experience Of Secondary School Teachers During The Covid-19 Pandemic, Diane R. Lovett
Lived Experience Of Secondary School Teachers During The Covid-19 Pandemic, Diane R. Lovett
Walden Dissertations and Doctoral Studies
The study emphasizes the need for a deeper understanding of secondary school teachers' experiences during the COVID-19 pandemic, particularly focusing on their challenges during the transition back to in-person instruction after teaching online. The purpose of this phenomenological study explored the experiences of U.S. secondary teachers during the onset of COVID-19, the shift to virtual teaching, and the return to in-person instruction. The study was grounded in Bandura’s (1986) social cognitive theory, specifically the concept of observational learning and self-efficacy, to understand how teachers learned from peer successes and challenges during the transition to virtual learning and when returning to …
Staff Education To Increase Knowledge Of Universal Protocol And Surgical Readiness Documentation Among Ambulatory Surgery Staff, Miranda Gould
Staff Education To Increase Knowledge Of Universal Protocol And Surgical Readiness Documentation Among Ambulatory Surgery Staff, Miranda Gould
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project evaluated the impact of a structured staff educational intervention on ambulatory surgery center (ASC) staff knowledge of Universal Protocol and SOAP (Surgeon, Operating Room, Anesthesia, and Preprocedure Ready) documentation. A practice gap was identified in staff knowledge of perioperative safety processes that are essential for preventing surgical safety events. The purpose of this doctoral project was to improve ASC staff knowledge of Universal Protocol and SOAP readiness documentation through an evidence-based educational intervention designed to strengthen perioperative safety practices. The practice-focused question was: According to the evidence, in multi-specialty ASC staff, what is …