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10-Bed Medical-Surgical Telemetry Unit Expansion To Address Inadequate Inpatient Capacity, Sumitpal Kaur
10-Bed Medical-Surgical Telemetry Unit Expansion To Address Inadequate Inpatient Capacity, Sumitpal Kaur
Walden Dissertations and Doctoral Studies
Inadequate medical-surgical telemetry capacity contributes to emergency department (ED) boarding, patient transfers, decreased patient satisfaction, and operational inefficiencies. This systems-level organizational leadership project evaluated a proposed 10-bed medical-surgical telemetry unit expansion at a medical center in Northern California. The project addressed the question of how a 10-bed expansion would affect ED boarding, patient crossovers to a nearby medical center, patient satisfaction, and financial performance. Trend analysis of occupancy, ED boarding, and crossover data, regional benchmarking, and financial modeling using net present value (NPV) and internal rate of return (IRR) were used to evaluate the proposed expansion. The organization currently operates …
Reducing Copd Readmissions Through An Evidenced-Based Clinical Practice Guideline, Courtney Rye
Reducing Copd Readmissions Through An Evidenced-Based Clinical Practice Guideline, Courtney Rye
Walden Dissertations and Doctoral Studies
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and hospital readmissions, with rural critical access hospitals (CAHs) facing unique challenges in delivering consistent, evidence-based care. At the pilot CAH medical–surgical unit, local chart review and practice observation revealed an approximately 18% 30-day COPD readmission rate and significant variation in discharge education, written action plans, inhaler technique assessment, and structured post‑discharge follow‑up. The purpose of this Doctor of Nursing Practice project was to develop and appraise an evidence‑based, Appraisal of Guidelines Research and Evaluation II (AGREE II) and Institute of Medicine–compliant COPD clinical practice guideline (CPG) to …
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
Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe
Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe
Walden Dissertations and Doctoral Studies
Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …
Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje
Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje
Walden Dissertations and Doctoral Studies
This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …
Kindergarten Teachers’ Challenges Embedding Play-Based Learning In A Standards-Based Curriculum, Anna Catalan
Kindergarten Teachers’ Challenges Embedding Play-Based Learning In A Standards-Based Curriculum, Anna Catalan
Walden Dissertations and Doctoral Studies
The problem addressed in this study was that kindergarten teachers in a Western United States elementary school were challenged by standards that have become heavily focused on teaching academic skills at a younger age, instead of teaching with developmentally appropriate practices that allow for play-based learning (PBL). Framed by Vygotsky’s theory of PBL, the purpose of this basic qualitative study was to explore what challenges local kindergarten teachers had when embedding PBL in a standards-based curriculum. Data were collected through 15 semistructured interviews with Kindergarten teachers who had at least 2 years' experience embedding PBL in instruction. Using thematic analysis …
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 …
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 …
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, …
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 …
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. …