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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 …
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 …
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 …
Experiences Of Child Welfare Workers In Ohio Serving Justice-Involved Youth Who Exhibit Aggressive Behaviors, Charnella Boykins
Experiences Of Child Welfare Workers In Ohio Serving Justice-Involved Youth Who Exhibit Aggressive Behaviors, Charnella Boykins
Walden Dissertations and Doctoral Studies
Social workers with high work demands and low resources are likely to experience burnout. The specific social work practice-focused research problems that were addressed in this project were job demands, available resources, and perceptions of burnout in child welfare social workers. The focus was on burnout in social work practice from the perspectives of child welfare social workers providing services to justice-involved children with aggressive behaviors. The practice-focused research questions for this project concerned the participants’ descriptions of job demands and employer-provided resources and their feelings of burnout when working with justice-involved youth who have aggressive behaviors. Bakker and Demerouti’s …
Development Of An Evidence-Based Clinical Practice Guideline For A Comprehensive Care Partner Program For Postpartum Women, Abibat Yusuff
Development Of An Evidence-Based Clinical Practice Guideline For A Comprehensive Care Partner Program For Postpartum Women, Abibat Yusuff
Walden Dissertations and Doctoral Studies
This doctoral project focuses on the development of a clinical practice guideline (CPG) aimed at addressing a critical gap in postpartum care, particularly postpartum depression (PPD), inconsistent follow-up, and low breastfeeding continuation rates, which disproportionately affect African American women and other underserved populations. These gaps contribute to preventable morbidity, poor maternal experiences, and health inequities, making this issue a priority for nursing and public health. The guiding practice-focused question asked if an interdisciplinary team would achieve consensus on a clinical practice guideline for the development of a comprehensive care partner program for postpartum women. Analytical strategies included a systematic evidence …
Executive Leadership System Improvement: System- Level Program To Improve Care For Type-Ii Diabetic Patients, Jane Chukwura
Executive Leadership System Improvement: System- Level Program To Improve Care For Type-Ii Diabetic Patients, Jane Chukwura
Walden Dissertations and Doctoral Studies
The DNP Scholarly Project presents the Diabetes Interprofessional Management Program, an organization-wide, logic-model–driven initiative to improve glycemic control, empower self-management, and advance health equity for adults with type II diabetes. The project leverages an interprofessional team, targeted training, culturally tailored education, health technology tools, and community partnerships to translate resources into team-based care, personalized plans, self-management support, and continuous education, with outputs including trained staff, engaged patients, and standardized care protocols. Short-term outcomes center on reduced mean HbA1c, more patients achieving HbA1c <7%, and widespread adoption of evidence-based pathways with standardized testing cadences. Long-term outcomes focus on fewer complications, higher patient satisfaction, and reduced disparities through the expansion of Diabetes Self-Management Education (DSME) and culturally appropriate resources, underpinned by robust data governance. The evaluation and implementation plan measures clinical outcomes, patient experience, and equity over 0–24 months, using formative metrics (workflow deployment, training, testing timeliness, DSME referrals, portal use) and summative metrics (HbA1c changes, HbA1c <7% at 12 months, hospitalizations, complications, knowledge and quality of life, equity indicators, and ROI). Governance features a Data Steering Subcommittee and quarterly dashboards. Deliverables include standardized protocols, DSME curricula, EHR workflows, training, and a scalable, sustainable model for broader deployment.
Executive Summary: Clinical Practice Guideline Guideline For Identifying Patients At Risk For Posttraumatic Stress Disorder (Ptsd), Doris Chinazo Dibia
Executive Summary: Clinical Practice Guideline Guideline For Identifying Patients At Risk For Posttraumatic Stress Disorder (Ptsd), Doris Chinazo Dibia
Walden Dissertations and Doctoral Studies
In this Doctor of Nursing Practice (DNP) project, I developed a clinical practice guideline to address the absence of a standardized process for identifying adult outpatients at risk for posttraumatic stress disorder (PTSD) in a community-based mental health clinic. Without such a process, delays in trauma-focused care and inconsistent referrals may occur. The evidence base supports the use of brief, validated screening tools, such as the Primary Care PTSD Screen for DSM-5, for accurate risk identification in routine practice. The practice-focused question that I used to guide this project was: Will an evidence-based guideline for PTSD risk identification be approved …
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 …
Junior-Level Women Experiences Influencing Their Departure From The U.S. Coast Guard, Jill Lynn Lazo
Junior-Level Women Experiences Influencing Their Departure From The U.S. Coast Guard, Jill Lynn Lazo
Walden Dissertations and Doctoral Studies
Despite increasing attention to public service motivation (PSM) in organizational research, there is a notable absence of studies examining the experiences of women in military contexts, particularly within the United States Coast Guard (USCG). This generic qualitative study, grounded in PSM theory, explored why junior-level women in the USCG prematurely exited military service. While existing research on PSM and women is limited and none specifically focused on women in the USCG, this study addressed that gap by interviewing 16 junior-level women who had separated from the USCG between four and eight years prior. The purpose of the study was to …
Perceptions Of K–5 Teacher Challenges In Supporting Military-Connected Children Overseas Who Experience Trauma, Lachanda Garrison
Perceptions Of K–5 Teacher Challenges In Supporting Military-Connected Children Overseas Who Experience Trauma, Lachanda Garrison
Walden Dissertations and Doctoral Studies
Teachers serving U.S. military-connected students (MCS) overseas regularly address student trauma in the classroom that stems from relocation and separation events due to parents’ or guardians’ military service. The problem addressed in this study was that Grade K–5 teachers struggle to support overseas who experience trauma. The purpose of this basic qualitative study was to explore Grade K–5 teachers’ perceptions of the challenges to support MCS overseas who have experienced trauma. The study was guided by three principles from Soma and Allen’s trauma informed model, which emphasizes understanding trauma as an experience, prioritizing social and emotional skill development, and supporting …
Staff Education To Improve Provider Knowledge On Antibiotic Prescribing, Jessica Nicole Jaimez
Staff Education To Improve Provider Knowledge On Antibiotic Prescribing, Jessica Nicole Jaimez
Walden Dissertations and Doctoral Studies
Summary This Doctor of Nursing Practice (DNP) staff education project addressed a gap in guideline-based antibiotic prescribing among advanced practice registered nurses (APRNs) in an urgent care setting. The practice problem identified at the local project site was inconsistent adherence to Centers of Disease Control and Prevention (CDC) outpatient stewardship expectations, resulting in unnecessary antibiotic use for viral conditions and contributing to antimicrobial resistance. The practice-focused question for this project was as follows: In urgent care APRNs, does implementing a staff education program on guideline-based antibiotic prescribing improve provider-reported knowledge on antibiotic prescribing use? The purpose of this doctoral project …
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 …
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 …
Effective Strategies For Managing Employee Resistance During Organizational Change In Healthcare Settings, Jelela Nicole Curvey
Effective Strategies For Managing Employee Resistance During Organizational Change In Healthcare Settings, Jelela Nicole Curvey
Walden Dissertations and Doctoral Studies
Employee resistance to organizational change reflects significant challenges for healthcare organizations. Healthcare leaders are concerned with employee resistance as it negatively influences patient care outcomes. Grounded in Lewin’s three-stage change model, the purpose of this qualitative pragmatic inquiry project was to identify and explore successful strategies healthcare leaders used to manage employee resistance during organizational change. Six healthcare leaders participated, each of whom had successfully implemented change initiatives while minimizing resistance. Data were collected through semistructured interviews and publicly available documents. Through thematic analysis, three themes emerged: (a) transparent communication and employee involvement, (b) supportive leadership behavior and emotional intelligence, …
Structured Follow-Up After Outpatient Visits: A Clinical Practice Guideline, Jeanette Serrano
Structured Follow-Up After Outpatient Visits: A Clinical Practice Guideline, Jeanette Serrano
Walden Dissertations and Doctoral Studies
I conducted this Doctor of Nursing Practice (DNP) project to develop an evidence-based clinical practice guideline (CPG) to reduce missed follow-up appointments and improve care continuity in a family medicine outpatient clinic. Missed follow-ups, especially common in underserved populations, compromise safety, delay treatment, and increase costs. The purpose of this doctoral project was to develop and appraise a CPG that integrates evidence-based strategies to improve follow-up procedures, reduce missed appointments, and enhance patient safety and care continuity in an outpatient setting. This project addressed the practice-focused question: Will a CPG around structured follow-up for patient visits in an outpatient clinic …
The Perceptions Of Foster Care Alumni Who Are Recipients Of Pandemic Aid, Ashley Robinson
The Perceptions Of Foster Care Alumni Who Are Recipients Of Pandemic Aid, Ashley Robinson
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic heightened challenges for young adults transitioning from foster care to independence. Research shows that foster care alumni faced barriers in education, employment, housing, and health due to limited support networks. Yet, little is known about how emergency policies, such as the Consolidated Appropriations Act (CAA) of 2021, affected them. The purpose of this qualitative study was to explore the perceptions and experiences of foster care alumni who received financial aid through the Act. The research question: What were the experiences and perceptions of foster care alumni (aged 18-26) who received funds via the CAA of 2021 during …
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 …
Developing A Clinical Practice Guideline For Screening Patients With Generalized Anxiety Disorder, Ijeoma Christiana Onyeagocha
Developing A Clinical Practice Guideline For Screening Patients With Generalized Anxiety Disorder, Ijeoma Christiana Onyeagocha
Walden Dissertations and Doctoral Studies
No Abstract Available
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? …
Improving Discharge Planning To Reduce Readmissions In Non-Teaching Urban Hospitals, Darlene Michelle Taylor
Improving Discharge Planning To Reduce Readmissions In Non-Teaching Urban Hospitals, Darlene Michelle Taylor
Walden Dissertations and Doctoral Studies
Hospital discharge planning is a critical determinant of patient outcomes, organizational performance, and financial sustainability. Many non-teaching urban hospitals continue to struggle with high readmission rates, especially among socially vulnerable populations such as the homeless. The purpose of this integrative review was to examine discharge planning strategies that would reduce readmissions, enhancing patient throughput, and mitigating financial penalties in non-teaching urban hospitals. The review question focused on effective discharge planning strategies that would improve readmission rates in non-teaching urban hospitals. A systematic integrative review of peer-reviewed studies published between 2020 and 2025 was conducted and 25 quantitative and qualitative studies …
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 …
Development Of An Evidence-Based Clinical Practice Guideline For Discharging Patients With Substance Use Disorder (Sud) From Outpatient Treatment To Community Care, Emmanuel Onyeani
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addressed a gap in practice in an outpatient treatment center for discharging patients with substance use disorder (SUD), addressing the need for follow-up care and relapse prevention due to the widespread impact of SUD. Clinical practice guidelines (CPG) help healthcare professionals make informed decisions for specific clinical situations. The guiding question asked whether an expert panel would evaluate and validate a CPG developed from current, evidence-based literature and recommendations with 70% agreement using the AGREE II tool. The CPG focused on continuity of care, access to resources, and relapse prevention strategies. Seven expert …
Google Search Trends And Their Correlation With Covid-19 Cases And Vaccination Rates In Austria, Stefanie Wendell
Google Search Trends And Their Correlation With Covid-19 Cases And Vaccination Rates In Austria, Stefanie Wendell
Walden Dissertations and Doctoral Studies
Timely digital surveillance is essential because clinical reporting often lags. This quantitative, longitudinal correlational study tested whether weekly Google searches in Austria signal changes in COVID-19 cases and vaccination uptake, and short-term case-vaccination dynamics, guided by Rogers’ Diffusion of Innovations Theory. Weekly Google Trends indices (0-100) and nationally reported surveillance totals (weekly counts of new cases and vaccine doses) were aggregated; cases: N = 175 weeks (Feb 2020–Jun 2023); vaccinations: N = 132 weeks (Dec 2020–Jun 2023). Time series correlations and lagged growth models showed that symptom-related searches consistently rose 1 week before reported cases (Δlog cases_t on Δlog searches_{t−1}: …
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
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% …
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 …
The Predictive Power Of Social Engagement On Psychological Outcomes Among College Students, Allison J. Gamble
The Predictive Power Of Social Engagement On Psychological Outcomes Among College Students, Allison J. Gamble
Walden Dissertations and Doctoral Studies
Worsening mental health among college students post-COVID is a growing national health crisis. Grounded in Cacioppo’s evolutionary theory of loneliness and Feeney and Collins’ thriving through relationships theoretical perspectives, the purpose of this study was to explore the degree to which social interaction and social support predicted psychological outcomes among undergraduate students. Survey responses from over 74,000 undergraduate students who completed the ACHA-NCHA survey for Fall 2019, 2021, and 2022 were analyzed. The surveys included the Kessler 6 screening for non-specific mental illness, the Diener flourishing scale, and questions to assess the number of hours spent in categorically-sorted social situations …