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Advancing Palliative Care Competency Through An Evidence-Based Educational Intervention For Healthcare Providers, Lauren Elizabeth Griffin
Advancing Palliative Care Competency Through An Evidence-Based Educational Intervention For Healthcare Providers, Lauren Elizabeth Griffin
Walden Dissertations and Doctoral Studies
A major gap in acute care is the delayed initiation of palliative consultations. Although over 58 million people worldwide could benefit, only 14% receive such care. Despite evidence that early involvement improves outcomes, providers often overlook their value, leading to late referrals, typically after repeated hospitalizations or near end-of-life, when hospice may be more appropriate. This Doctor of Nursing Practice (DNP) educational intervention addressed a critical practice-focused question to enhance healthcare providers’ understanding of palliative care improve hospital-based patient outcomes. The intervention aimed to demonstrate a ≥20% knowledge gain from pretest to posttest scores related to distinguishing palliative care from …
Integrating Psychotherapy And Medication Management In A Primary Care Clinic, Patricia Nkhono
Integrating Psychotherapy And Medication Management In A Primary Care Clinic, Patricia Nkhono
Walden Dissertations and Doctoral Studies
A knowledge deficit in integrating supportive psychotherapy with medication management to treat patients’ psychiatric challenges was identified in a primary care clinical setting. I developed a staff education project to close the knowledge gaps of nurses and nurse practitioners related to an evidence-based protocol that incorporated supportive therapy in individualized treatment plans. The project’s aim was to develop, implement, and evaluate the staff education program. The focused project question centered on whether staff education would increase staff knowledge and drive increased supportive therapy orders at admission of patients. Clinical staff registered nurses and nurse practitioners (N = 5) participated in …
Experiences Of Formerly Incarcerated College Minority Men Criminalized For Behavioral Issues, Francine Zysk
Experiences Of Formerly Incarcerated College Minority Men Criminalized For Behavioral Issues, Francine Zysk
Walden Dissertations and Doctoral Studies
The school-to-prison pipeline, where minority men experience decreased academic performance, higher truancy rates, and increased vulnerability to arrest, persists in the United States. The purpose of this qualitative study was to explore how systemic racism is experienced by formerly incarcerated, college-educated Black men who were criminalized for behavioral issues that contributed to their incarceration. The research problem was a lack of knowledge of the experiences of educational environments and disciplinary systems that perpetuate racialized behavioral labeling and contribute to the school-to-prison pipeline. Grounded in the theoretical framework of institutional racism, the study featured a constructivist paradigm to capture participants' experiences. …
The Stress Parents Face When Their Autistic Child Turns 21, Everetta Joyce Irene Davis
The Stress Parents Face When Their Autistic Child Turns 21, Everetta Joyce Irene Davis
Walden Dissertations and Doctoral Studies
This exploratory study examined the lived experiences of parents whose autistic children turned 21 and aged out school and services provided by the federally funded Free Appropriate Public Education (FAPE) program. Although researchers have conducted numerous studies on autism, limited research has focused specifically on the stress parents face when their autistic child turns 21 and loses access to FAPE. The purpose of this qualitative narrative inquiry was to gain a deeper understanding of the emotional, logistical, and systemic challenges these parents encountered during the transition out of high school. Family Systems Theory provided the conceptual framework for exploring these …
The Lived Experience Of U.S. Law Enforcement Officers And The Challenges They Face While Investigating Sexual Assault Victim Reports, Ariekan Josephs-Greene
The Lived Experience Of U.S. Law Enforcement Officers And The Challenges They Face While Investigating Sexual Assault Victim Reports, Ariekan Josephs-Greene
Walden Dissertations and Doctoral Studies
Sexual assault is a pervasively dangerous crime affecting persons of all ages, races, and genders, both in the United States and globally. Essential in the safeguarding of American citizens, U.S. law enforcement officers are among the first responders on scene to investigate reports of sexual assault claims. However, echoed in previous research are the sentiments of victim-survivors who experienced negative encounters with officers who exhibited an implicit lack of victim-centered training and were dismissive in their investigative approach. Consequently, this gap in the literature requires exploration; therefore, this study focuses on the lived experiences of U.S. law enforcement officers and …
Staff Education To Reduce Relapse Rates Among Individuals With Substance Use Disorders, Joyce Chioma Nwakor
Staff Education To Reduce Relapse Rates Among Individuals With Substance Use Disorders, Joyce Chioma Nwakor
Walden Dissertations and Doctoral Studies
The program created a more encouraging recovery environment by greatly increasing staff competency in relapse prevention. Staff reported having more conversations with patients about preventing relapses. These enhancements might result in lower relapse rates and better long-term recovery outcomes.
How Law Enforcement Officers’ Perceived Public And Self-Stigma Predicts Their Willingness To Seek Mental Health Services, Elizabeth Mae Mooney
How Law Enforcement Officers’ Perceived Public And Self-Stigma Predicts Their Willingness To Seek Mental Health Services, Elizabeth Mae Mooney
Walden Dissertations and Doctoral Studies
The work of previous researchers has shown officers to have higher rates of depression, posttraumatic stress disorder (PTSD), generalized anxiety, and suicidality than the public, and a lower rate of mental health service-seeking. Stigma, both public and self-stigma, has been revealed by previous researchers to be the predominant barrier that deters officers from seeking out needed and/or desired services. A gap in research existed in examining alternative service types, and whether law enforcement officers perceived these service types as more or less stigmatizing than traditional methods. This study employed a quantitative research design to predict the probability that law enforcement …
Patient Safety In Ambulatory Hysteroscopy, Myko Lanier
Patient Safety In Ambulatory Hysteroscopy, Myko Lanier
Walden Dissertations and Doctoral Studies
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Employee Perception Of Administrator Leadership Behaviors In Southeastern U.S. Hospitals That May Contribute To Employee Turnover, Kim Steele
Walden Dissertations and Doctoral Studies
Given the increasing significance of employee turnover, administrative leadership in U.S. Southeastern hospitals stands at a critical turning point. The specific research problem is that leadership behaviors may create an intolerable environment for employees, leading to an intent to leave and turnover. The purpose of this descriptive phenomenological study was to explore administrative leadership behaviors that contribute to employee turnover, with a specific focus on leadership behaviors in U.S. Southeastern hospitals. The conceptual framework included grounded theory, which examines underlying social processes, and behavioral theory, focusing on leadership practices and behavior change. Fifteen administrative employees, four men and 11 women, …
Strategies To Reduce Emergency Department Overcrowding At Hospitals In Puerto Rico, Nicole Melissa Rivera Sánchez
Strategies To Reduce Emergency Department Overcrowding At Hospitals In Puerto Rico, Nicole Melissa Rivera Sánchez
Walden Dissertations and Doctoral Studies
Emergency department (ED) overcrowding has become an increasingly critical issue for the healthcare system of Puerto Rico, resulting in delayed care and increased patient morbidity, among other challenges faced by hospital leaders and administrators. This paper explores evidence-based strategies tailored to the Puerto Rican healthcare context to alleviate ED overcrowding. An integrative review of literature published between 2020 and 2025 was conducted. For this review, 15 articles were selected and appraised using the Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals. The strategies gleaned from the literature comprised six themes and 21 subthemes, centered on two major outcomes: …
Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene
Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addresses the pervasive health issue of burnout among healthcare providers, focusing on a community mental health clinic where internal data revealed high levels of staff turnover, absenteeism, medication errors, financial constraints, poor patient outcomes, and low staff satisfaction. Shortage of healthcare providers, exposure to patient trauma, high emotional demands, and administrative burdens are the systemic stressors of burnout at the project site mental health facility. These factors collectively underscored the need for a system-wide burnout reduction program to safeguard provider well-being and ensure the delivery of high-quality patient care and safety.
Staff Education To Improve Phq-9 Depression Screening And Management In Primary Care, Elizabeth Ezeamaka
Staff Education To Improve Phq-9 Depression Screening And Management In Primary Care, Elizabeth Ezeamaka
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice staff education project aimed to improve staff knowledge and enhance the consistency in administering and interpreting the Patient Health Questionnaire-9 (PHQ-9) within a mental health clinical setting. The practice problem was significant because variability in PHQ-9 use resulted in unreliable depression screening data, potentially leading to missed detection of depression or suicidal ideation, which undermines patient safety and quality of care. The guiding practice-focused question was: Among healthcare staff administering the PHQ-9, what effect does an educational program have on their knowledge related to the administration, documentation, and interpretation of depression screening? The purpose of …
Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay
Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay
Walden Dissertations and Doctoral Studies
Summary This DNP staff education project focused on improving staff knowledge on self-care management of hypertension. The overarching patient care problem at the project site was uncontrolled hypertension among adult patients with lack of staff knowledge and confidence in delivering related patient education. Addressing uncontrolled hypertension is vital within nursing practice due to its impact on public health and the opportunity for a nurse-led evidence-based intervention to improve patient outcomes. The practice-focused question for this project was: “In adults with uncontrolled hypertension, does staff education program on hypertension self-care management improve staff knowledge on how to educate patients on self-care …
Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri
Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri
Walden Dissertations and Doctoral Studies
Universal staff training to increase the validity and reliability of adolescent mental health screening was implemented in this quality improvement (QI) initiative. Depression and anxiety disorders often emerge between ages 12 and 17, yet evidence-based screening measures such as the Patient Health Questionnaire (PHQ-9/PHQ-9M) and Generalized Anxiety Disorder (GAD-7) are underutilized due to provider knowledge gaps, workflow inefficiencies, and cultural barriers. Guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, the project evaluated whether structured staff education improved early identification and diagnosis of adolescent depression and anxiety compared to routine practice. In workshops, web-based learning modules, case simulations, and …
Development And Implementation Of A Treatment History And Authorization Checklist To Improve Access To Spravato Therapy For Treatment-Resistant Depression, Margaret Mae Scott
Development And Implementation Of A Treatment History And Authorization Checklist To Improve Access To Spravato Therapy For Treatment-Resistant Depression, Margaret Mae Scott
Walden Dissertations and Doctoral Studies
Background: Treatment-resistant depression (TRD) presents a significant clinical and administrative challenge, delaying access to evidence-based therapies such as intranasal esketamine (Spravato). Inconsistent documentation and lack of standardized clinical pathways contribute to insurance authorization delays, exacerbating health inequities and care fragmentation. Purpose: This DNP project aimed to develop and implement a standardized Treatment History Checklist and Clinical Practice Guideline to streamline documentation, support timely insurance authorization, and promote equitable access to Spravato therapy for patients with TRD. Methods: Using a systems change framework, the project employed gap analysis, stakeholder engagement, and iterative validation to design tools aligned with payer requirements and …
U.S. Government Software Development Entity Implements A Hybrid Of Waterfall And Agile To Address Failures, Dwight Jerome Peters Jr.
U.S. Government Software Development Entity Implements A Hybrid Of Waterfall And Agile To Address Failures, Dwight Jerome Peters Jr.
Walden Dissertations and Doctoral Studies
Although organizations allocate substantial resources to software development process initiatives, a significant portion of these projects fail. The U.S. government software development leaders and managers need to understand the disadvantages of both waterfall and agile methodologies as leading indicators of project failure. Grounded in the diffusion of innovation theory, the purpose of this qualitative case study was to explore the consequences in government software development fostered by a hybrid approach of waterfall and agile methodologies pertaining to the inherent shortcomings of each methodology. The participants consisted of four current and four former team members from the U.S. government software development …
Increasing Knowledge And Awareness Of Cultural Competency Among Providers, Veronica Rodriguez
Increasing Knowledge And Awareness Of Cultural Competency Among Providers, Veronica Rodriguez
Walden Dissertations and Doctoral Studies
In today’s challenging healthcare environment, coupled with increasing global migration, healthcare delivery has become more diverse, and providers must deliver high-quality, patient-centered care across diverse populations. Cultural competency, the ability to understand and effectively interact with patients from diverse backgrounds, is essential for reducing health disparities, improving patient satisfaction, and enhancing health outcomes. However, many providers struggle to integrate these practices into daily care due to limited or inconsistent knowledge on applying these concepts in real-world settings. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine whether an educational intervention focused on cultural competency increased …
The Nurse's Role In Patient Preparation For Discharge To Optimize Patient Outcomes And Reduce Readmissions, Marie-Antoinette Chevrin
The Nurse's Role In Patient Preparation For Discharge To Optimize Patient Outcomes And Reduce Readmissions, Marie-Antoinette Chevrin
Walden Dissertations and Doctoral Studies
For this Doctor of Nursing Practice (DNP) project, I created a staff education initiative aimed at enhancing nurses’ understanding of heart failure (HF) and clarifying their role within clinical pathways for managing decompensated HF. HF is a common and complex condition, accounting for 1-2% of hospital admissions. In response to the rising 30-day readmission rate and lack of a standardized discharge protocol, an evidence-based staff education program was developed. According to the “ACC/AHA/HFSA 2022 HF guidelines”, effective prevention and management require nurses to understand causes, risk factors, and pathophysiology of HF, along with their role in patient-centered care. Nurses routinely …
Depression Screening In Veterans And Active-Duty Service Members With Chronic Pain, Lynelle Marie Endsley
Depression Screening In Veterans And Active-Duty Service Members With Chronic Pain, Lynelle Marie Endsley
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project addressed the absence of evidence-based depression screening among military members and veterans with chronic pain. Contrary to national guidelines, no standardized depression screening process was in place. This gap in practice was attributed to inadequate staff knowledge and understanding in using such tools. The purpose of this project was to evaluate whether staff education on the Patient Health Questionnaire-9 (PHQ-9) improved knowledge and confidence, in evaluating for and identifying depression in a high-risk population. The practice-focused question asked: Will staff education on the importance and consistent use PHQ-9 increase knowledge and confidence in depression …
Development Of An Evidence-Based Educational Intervention To Advance Nurse Knowledge In Comprehensive Care Of Patients With Congestive Heart Failure, Jessica Smith
Walden Dissertations and Doctoral Studies
The Doctor of Nursing Practice (DNP) project was a staff education intervention to increase nursing staff knowledge. Congestive heart failure (CHF) remains one of the leading causes of hospitalizations and has the highest readmission rates within 30 days of a previous admission. Consistent evidence reveals improving nursing knowledge reduces complications, improves self-management support, lowers readmission rates in this particular patient population. The DNP project was developed as a staff education intervention and focused on 30 nurses working on a telemetry unit in an acute care hospital. The project question was whether an educational intervention would increase general nursing knowledge caring …
Perpetration-Induced Traumatic Stress And Moral Injury In Adult Male Incarcerated Individuals, Cyrelah Jeanee Raynor
Perpetration-Induced Traumatic Stress And Moral Injury In Adult Male Incarcerated Individuals, Cyrelah Jeanee Raynor
Walden Dissertations and Doctoral Studies
Underutilizing trauma-informed approaches in correctional rehabilitation has had detrimental consequences, particularly for gang-involved populations. Theories of personality, responsivity, and stress suggest that gang-affiliated individuals, shaped by coercive environments, may develop psychological reactions such as fear, guilt, and moral shame that contribute to posttraumatic stress disorder (PTSD) and moral injury (MI). This study examined whether gang role, psychopathy, and perpetration predicted PTSD and MI among 70 incarcerated adult males. Participants completed the Moral Injury Outcome Scale (MIOS), the PTSD Checklist for DSM-5 (PCL-5), and the Levenson Self-Report Psychopathy Scale (LSRP). Two hierarchical regressions were conducted. In the PTSD model, only education …
Executive Summary: Staff Education Project Staff Education To Close A Knowledge Gap Regarding Restraints, Aaron Ross Ledbetter
Executive Summary: Staff Education Project Staff Education To Close A Knowledge Gap Regarding Restraints, Aaron Ross Ledbetter
Walden Dissertations and Doctoral Studies
The purpose of this Executive Summary is to address a gap in knowledge that I attempted to close regarding restraint utilization. Restraints, both physical and chemical, have been prevalent over the past ten years and with their increased utilization during the pandemic which has continued post-pandemic. Nursing as a culture has become more reliant on restraints as it allows more time for nurses to provide care elsewhere. Both physical and psychological complications have been recognized during the utilization of physical restraints. Their prominence, although helpful with time constraints for nurses, have shown to negatively impact the patients who they are …
Staff Education To Improve Medicare Lung Cancer Screening And Processes, Ashley Mccammon
Staff Education To Improve Medicare Lung Cancer Screening And Processes, Ashley Mccammon
Walden Dissertations and Doctoral Studies
The doctoral project was a staff education initiative to address underutilization of low-dose computed tomography (LDCT) lung cancer screening among Medicare-eligible patients at the project site. Lung cancer is the leading cause of cancer death, and LDCT screening reduces mortality by up to 20%. Internal data from the project site revealed that only 20.13% of eligible patients completed screening, underscoring the need for structured staff education to improve knowledge and support early detection. The practice focused question asked: Will a staff education on Medicare LDCT screening and processes increase staff knowledge towards the ultimate goal of increasing LDCT screening rates? …
Disability Accommodations In Field Education: Exploring The Msw Student Perspective, Alicia Dawn Melnick
Disability Accommodations In Field Education: Exploring The Msw Student Perspective, Alicia Dawn Melnick
Walden Dissertations and Doctoral Studies
The number of students with disabilities is increasing, yet little is known about how graduate social work students navigate accommodation during field placements. This study addressed the limited understanding of Master of Social Work (MSW) students’ experiences applying Americans with Disabilities Act (ADA) accommodations in practicum settings. How accommodations are managed can determine whether disabled students gain equitable access to training and the profession. The purpose of this exploratory qualitative study was to examine how MSW students with disabilities describe their experiences with applying ADA accommodations during field placements. Critical disability theory guided the study, emphasizing ableism and structural barriers …
Critical Food Safety Violations In Food Facilities By Regions Across Calgary Communities From 2022 Versus 2023, Kamorudeen Olayinka Bakare
Critical Food Safety Violations In Food Facilities By Regions Across Calgary Communities From 2022 Versus 2023, Kamorudeen Olayinka Bakare
Walden Dissertations and Doctoral Studies
Critical food safety violations in food facilities are severe infractions that may affect the quality and safety of foods as well as the health and wellbeing of consumers in Canada. In 2023, Alberta Health Services heightened scrutiny on these violations in Calgary. However, no investigation has been undertaken to document its potential effects on types and trend (from the previous year) of food safety violations in food facilities across Calgary regions. The purpose of this quantitative study was to examine the associations between Calgary regions of Canada, Year (2022 versus 2023), and the number of types of critical food safety …
Enhancing Home Health Nursing Knowledge Through Targeted Education On Polypharmacy Risk Awareness In Older Adults, Chinyeaka Linda Ogbonna
Enhancing Home Health Nursing Knowledge Through Targeted Education On Polypharmacy Risk Awareness In Older Adults, Chinyeaka Linda Ogbonna
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) staff education initiative addressed the problem of polypharmacy, a common issue in home health care that increases the risk of drug interactions, side effects, and hospitalizations. Nurses and aides often provide daily care but may not recognize high-risk medications or warning symptoms. Addressing this gap was vital to nursing practice because staff are on the front line of patient monitoring and safety. The practice-focused question asked whether structured education for home health staff would improve knowledge of polypharmacy risks by 20%, increase recognition of high-risk medications by 75%, and result in at least 75% …
Challenges And Successes In Retaining Direct Support Professionals For People With Intellectual And Developmental Disabilities In Group Home Settings, Erica Kay Evans
Challenges And Successes In Retaining Direct Support Professionals For People With Intellectual And Developmental Disabilities In Group Home Settings, Erica Kay Evans
Walden Dissertations and Doctoral Studies
Abstract Challenges and Successes in Retaining Direct Support Professionals for People with Intellectual and Developmental Disabilities in Group Home Settings by Erica Kay Evans MA, Walden University, 2016 BA, University of Phoenix, 2013 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Education Walden University November 2025
The Relationship Between Theory Of Planned Behavior Constructs And Small Business Owners’ Tax Evasion And Avoidance Behaviors, Kenyatta Patton
The Relationship Between Theory Of Planned Behavior Constructs And Small Business Owners’ Tax Evasion And Avoidance Behaviors, Kenyatta Patton
Walden Dissertations and Doctoral Studies
The U.S. Department of the Treasury incurs substantial costs due to a tax gap, and the U.S. Internal Revenue Service has limited capacity to implement non-enforcement strategies without a deeper understanding of the behavioral drivers of tax non-compliance. Grounded in the theory of planned behavior, the purpose of this quantitative, correlational study was to explore the relationships between small business owners’ attitudes toward taxation, social norms, perceived behavioral control, and tax compliance behaviors. The participants comprised 121 small business owners in the Atlanta, Georgia, metropolitan area. They completed a combined survey consisting of the ethics of tax evasion survey instrument …
Staff Education To Internal Medicine Clinic, Rafael A. Cardona Gonzalez
Staff Education To Internal Medicine Clinic, Rafael A. Cardona Gonzalez
Walden Dissertations and Doctoral Studies
This is a staff education project. The practice problem addressed was the lack of standardized orientation on the electronic health record (EHR) system for rotating students, which impacted documentation quality and workflow efficiency. Prior to the intervention, students received no formal training on the clinic’s EHR system, resulting in documentation errors, workflow disruptions, and dependence on administrative staff. The educational session, tailored to the clinic’s EHR platform, aimed to promote student knowledge and confidence through structured, site-specific training. The practice-focused question was: How does structured education on site-specific EHR use impact knowledge and documentation confidence among rotating medical and nurse …
The Effects Of Pediatric Traumatic Brain Injury On Sexual Criminal Offense, Brooke Leslie Luckhardt
The Effects Of Pediatric Traumatic Brain Injury On Sexual Criminal Offense, Brooke Leslie Luckhardt
Walden Dissertations and Doctoral Studies
Traumatic brain injury during childhood and adolescence is a significant social problem and is particularly damaging to long term cognitive and mental health. Major growth and maturation occur within the brain from age 6 months to 25 years and any interruption to this process can be detrimental to long term cognitive and emotional adjustment. Research has shown that pediatric traumatic brain injury can cause aggression, agitation, mood disorder, and socially inappropriate behavior. However, the study of how sustaining a traumatic brain injury during the time of pediatric development could potentially affect future sexually inappropriate behavior has not been explored. This …