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Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape
Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape
Walden Dissertations and Doctoral Studies
Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% …
Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa
Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa
Walden Dissertations and Doctoral Studies
Pressure injuries that patients develop while hospitalized continue to be a major safety concern in hospitals treating very sick patients. These wounds hurt, make infections more likely, keep people in the hospital longer, and increase expenses. On many units, the steps meant to stop these injuries, like checking each patient's risk level and turning patients regularly are not carried out the same way for everyone. Because of this inconsistency, some patients develop preventable pressure injuries. The purpose of this Doctor of Nursing Practice (DNP) project was to create a clinical practice guideline (CPG) for organized pressure injury prevention and to …
Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan
Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan
Walden Dissertations and Doctoral Studies
The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …
English Language Arts Remedial Teachers’ Perspectives On Strategies To Close The Academic Achievement Gap Of Minority High School Students, Barbara Williams
English Language Arts Remedial Teachers’ Perspectives On Strategies To Close The Academic Achievement Gap Of Minority High School Students, Barbara Williams
Walden Dissertations and Doctoral Studies
The problem that was addressed throughout this study is that 53% of minority students do not reach proficiency on the English Language Arts (ELA) portion of the Florida Assessment of Student Thinking test compared to the 42% of other student populations at Grover High School (GHS, a pseudonym), a large and diverse high school, despite targeted school improvement interventions each school year. Grounded in Ladson-Billings’s culturally relevant pedagogy, the purpose of this basic qualitative study was to investigate ELA remedial teachers’ perspectives on reading strategies and instructional planning tools that might help minority students close the academic achievement gap. Semistructured …
Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise
Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise
Walden Dissertations and Doctoral Studies
Delirium is a preventable and manageable neuropsychiatric condition characterized by acute fluctuations in attention, awareness, and cognition. The burden of this acute confusion syndrome among older adults aged > 65 years is disproportionate higher, due to age-related neurocognitive vulnerabilities. Nurse-led delirium prevention interventions can reduce incidence from 70% to 20% following structured education, gaps persist in nursing knowledge around evidence-based prevention strategies. The purpose of this project was to evaluate whether a structured nursing education intervention on enhanced mobility and sensory aid optimization strategies, as components of the ABCDEF bundle, improved nursing knowledge compared to standard care practices. Nineteen registered nurses …
Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi
Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi
Walden Dissertations and Doctoral Studies
This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …
Effective Leadership Strategies To Retain For-Profit Education Employees After A Leadership Change, Kimberly Keene
Effective Leadership Strategies To Retain For-Profit Education Employees After A Leadership Change, Kimberly Keene
Walden Dissertations and Doctoral Studies
Ineffective leadership transitions in for profit higher education erode employee morale, trust, and retention. Higher education business leaders recognize that ineffective leadership transitions can contribute to employee disengagement, reduced organizational commitment, and increased turnover, undermining institutional stability, workforce continuity, and organizational performance. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the effective leadership strategies used by for-profit education institution leaders to retain key employees after a change in leadership. The participants were 10 leaders employed at for-profit higher education institutions in the southern United States who had successfully implemented leadership strategies …
Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala
Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala
Walden Dissertations and Doctoral Studies
Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …
The Exploration Of Pandemic Educational Equity Among Virginia Schools, James Edward Graves
The Exploration Of Pandemic Educational Equity Among Virginia Schools, James Edward Graves
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic intensified existing educational inequities among marginalized student populations, prompting unprecedented federal investments through the Coronavirus, Aid, Relief, and Economic Security (CARES) Act to support educational continuity. Existing literature findings consistently demonstrated that collaborative leadership, equitable resource allocation, family engagement, and community partnerships improved educational continuity, which reduced learning disparities during the COVID-19 pandemic. Despite substantial resource allocations, limited research has examined parent perceptions regarding the equity and effectiveness of CARES Act-supported educational interventions. The purpose of this generic qualitative study was to explore Virginia high school parents' perceptions of pandemic educational equity, CARES Act financial disbursement strategies, …
Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso
Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso
Walden Dissertations and Doctoral Studies
The transition from student nurse to professional practice remains a vulnerable period marked by role ambiguity, stress, and early turnover. At a large medical center, the lack of a structured bridge between the final capstone experience and the residency program contributed to inconsistent onboarding, reduced confidence, and diminished resilience among new graduates. Addressing this gap is essential for strengthening retention, supporting workforce stability, and improving patient outcomes within nursing practice. An evidence‑based clinical practice guideline (CPG) outlining best‑practice recommendations for a new graduate transition program from capstone to residency was developed for the facility. The practice‑focused question asked whether the …
Reducing No-Show Rates In An Outpatient Behavioral Health Clinic Through A Multimodal Patient Engagement Intervention, Gwendoline Osong
Reducing No-Show Rates In An Outpatient Behavioral Health Clinic Through A Multimodal Patient Engagement Intervention, Gwendoline Osong
Walden Dissertations and Doctoral Studies
Reducing No-Show Rates in an Outpatient Behavioral Health Clinic Through a Multimodal Patient Engagement Intervention
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. …
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 …
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 …
General Education Teachers’ Perceptions Regarding Supporting Students With Autism Spectrum Disorder In Inclusive Elementary Mainstream Classrooms In Central California, Leah Blake
Walden Dissertations and Doctoral Studies
The problem addressed in this study was a gap in practice about general education teachers’ support of students with autism spectrum disorder (ASD) in inclusive elementary mainstream classrooms in Central California, where regional inclusion rates fall below state and national averages. Grounded in Universal Design for Learning, the purpose of the study was to explore general education teachers’ perceptions regarding inclusion and recommended support for students with ASD in inclusive elementary mainstream classrooms. For this basic qualitative study, semistructured interviews were conducted with 12 general education teachers who taught grades 1 through 6. Through open, in vivo, and subsequent axial …
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 …
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 …
Strategies To Improve Communication Among Culturally Diverse International Manufacturing Teams, Bessem Enow Nchenge
Strategies To Improve Communication Among Culturally Diverse International Manufacturing Teams, Bessem Enow Nchenge
Walden Dissertations and Doctoral Studies
Inefficient communication and insufficient collaboration in multicultural organizations can result in suboptimal team performance and stifle employee creativity. Manufacturing firm leaders who struggle with communication issues are concerned about deterioration in team cohesion, worker productivity, and information flow. Grounded in the theory of planned behavior, this qualitative, pragmatic inquiry research project explored strategies that leaders of international manufacturing firms use to bridge cultural differences and improve communication among international team members to enhance team performance. The participants were six leaders from manufacturing firms in the southwestern United States with international manufacturing agreements who demonstrated measurable success in improving communication among …
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 …
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 …
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 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 …
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 …