Digital Commons Network^™

Experiences Of Resilience During Divorce For Black Women Who Attend Church, Tracey Ann Grant

Walden Dissertations and Doctoral Studies

Across the globe, divorce is a challenging situation that affects family relationships and disrupts social networks. Divorced women often experience a decline in their health and well-being immediately postdivorce. The problem addressed in this study is that divorcing women tend to experience more negative or undesirable impacts on their mental health (e.g., depression) postdivorce than men and often find involvement in church to be a source of support or added stress. The purpose of this generic qualitative study was to investigate how recently divorced Black women describe how their involvement in church may have supported their mental health and resilience …

Implementation Of A Structured Safety Planning Intervention In An Outpatient Psychiatric Setting, Ellen Riccio

Walden Dissertations and Doctoral Studies

This organization change process evaluation addressed continued reliance on outdated no-suicide and no-harm contracts in an outpatient psychiatric setting, despite evidence that such contracts do not reduce suicide risk and may create a false sense of security. Adult outpatients with mood or psychotic disorders who express safety concerns represent a population for whom structured, collaborative safety planning is the accepted standard of care. Addressing this gap is central to patient safety and quality nursing care. The practice-focused question asked whether replacing no-suicide contracts with a structured, six-step Safety Planning Intervention would influence safety events, self-harm behaviors, and psychiatric hospitalizations among …

Staff Education To Reduce Stress In Assisted Living Nursing Staff, Cherechi Onyenso

Walden Dissertations and Doctoral Studies

In this staff education doctor of nursing practice (DNP) project, I addressed a practice gap associated with inadequate staff knowledge of workplace stress-management strategies in an assisted living facility. Workplace stress in nursing practice is a contributing factor to burnout, reduced job satisfaction, poor teamwork, and a decline in the quality of resident care. The practice-focused question for this project was about whether staff knowledge would be enhanced over an 8-week period in comparison to baseline knowledge as a result of their participation in a structured staff education program on workplace stress management. The purpose of the project was to …

Effective Strategies For Retaining Nonofficer Talent In Retail Banking, Janique Johnson

Walden Dissertations and Doctoral Studies

Retail banking organizations lose billions of dollars annually to nonofficer employee turnover, disrupting operations, degrading customer service, and burdening human resource (HR) leaders with repeated recruitment costs. When retail bank HR leaders experience nonofficer employee turnover among their frontline workforces, it can influence profitability and community trust. Grounded in stakeholder theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies used by retail bank HR leaders to retain nonofficer talent. The participants were 10 HR leaders in U.S. retail banking institutions who had successfully implemented nonofficer retention strategies. Data were collected using semistructured interviews and …

Staff Covid-19 Infections, Staffing Shortages, And Resident Deaths In New York State Nursing Homes, Arun Inayatullah

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic intensified existing staffing challenges in U.S. nursing homes. Although previous studies have examined the effects of COVID-19 in nursing homes, limited research has examined the association between staff COVID-19 infection counts, staffing shortages, and resident COVID-19 deaths in New York State nursing homes. The purpose of this quantitative correlational study was to examine whether staff COVID-19 infection counts were associated with staffing shortages and resident COVID-19 deaths in New York State nursing homes. The study was guided by the Donabedian structure-process-outcome model. Analyses of the four research questions examined whether staff COVID-19 infection counts were associated with …

Staff Education To Improve Staff Knowledge, Confidence, And Intent To Consistently Implement Medication-Assisted Treatment, Matilda Boachie

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project addressed inconsistent medication-assisted treatment (MAT) implementation in a masked crisis stabilization unit. MAT was available, but staff education was informal and inconsistent, contributing to variation in knowledge, confidence, patient education, documentation, and discharge planning. The practice-focused question that was answered through this project was whether structured staff education would improve knowledge, confidence, and intent to consistently implement MAT. The purpose was to develop, implement, and evaluate structured education for interdisciplinary staff. De-identified pre- and post-education surveys were analyzed with descriptive statistics, and aggregate averages were compared because individual surveys were not matched. …

Staff Education To Improve C-Ssrs Suicide Risk Screening Competency, Pearl Binka

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed inconsistent administration and documentation of the Columbia-Suicide Severity Rating Scale (C-SSRS) in an acute care mental health setting. The practice problem was important because inconsistent standardized screening could delay identification of patients who required timely safety interventions. The practice-focused question examined whether structured C-SSRS education improved nursing staff competency, screening consistency, and documentation compliance. The project was developed and implemented to strengthen nurses’ knowledge, confidence, and skill in applying the C-SSRS as part of routine suicide risk screening. Evaluation strategies included comparisons of pre- and posteducation knowledge scores, competency checklist completion, chart audit findings, …

Implementation Of An Evidence-Based, Standardized Hypertension Follow-Up Protocol To Improve Quality And Outcomes Among African American Females In A Primary Care Setting, Fausat Oluremi Ojo

Walden Dissertations and Doctoral Studies

Hypertension is a major modifiable risk factor for cardiovascular disease, stroke, kidney disease, and premature mortality. African American women experience a disproportionate burden of hypertension and hypertension-related complications, making timely follow-up and treatment intensification essential quality and equity priorities. This evidence-based practice project implemented a standardized hypertension follow-up protocol in a primary care setting to improve blood pressure (BP) control and follow-up reliability among African American females ages 18 to 65 with a hypertension diagnosis. The project population included 67 patients, numbered 1 to 67. Baseline BP report data showed that 47 patients had BP less than 140/90 mm Hg, …

Hospital Operational Strategies For Reducing 30-Day Acute Myocardial Infarction Readmissions In The Southeast United States, Heather Smith

Walden Dissertations and Doctoral Studies

Thirty-day readmissions following acute myocardial infarction (AMI) remain a significant challenge for health care organizations due to increased health care utilization, costs, and adverse patient outcomes. The purpose of this integrative review was to identify effective operational strategies for reducing 30-day readmissions among patients with AMI in the Southeast United States. An integrative review of literature published between 2019 and 2026 was conducted using Cumulative Index to Nursing and Allied Health Literature, MEDLINE/PubMed, UAB Lister Hill Library, Walden Library, Scopus, American Heart Association, and Google Scholar. Twenty-five articles were appraised using the Johns Hopkins appraisal process, and 15 studies meeting …

Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler

Walden Dissertations and Doctoral Studies

Secondary postpartum hemorrhage (SPPH) is a significant contributor to maternal morbidity in the United States and occurs after hospital discharge during the postpartum period. Persistent disparities in terms of maternal outcomes suggest access to prenatal care alone may not adequately address clinical and social factors associated with SPPH. Guided by the Social Ecological Model, which recognizes that health outcomes are influenced by a collective approach to examining health. The purpose of this study was to examine associations between SPPH, prenatal care access, and social determinants of health from 2019 to 2022 while controlling for maternal age, race, and delivery type. …

Staff Education Project To Increase Nursing Staff Knowledge Of Falls Prevention In Long-Term Care Facility, Oludele Olagoke

Walden Dissertations and Doctoral Studies

Falls among residents in long-term care facilities are a concern for families and facility management. Falls inflict pain, discomfort, and head trauma, causing fractures. In nursing practice, falls are nursing-sensitive indicators that reflect the quality of nursing care and patient safety. There is a need to bridge the gap and increase staff knowledge on how to prevent falls in the facility. The Doctor of Nursing Practice (DNP) project focused on increased nursing staff knowledge through an evidence-based education program and the implementation of an evidence-based practice education program. The DNP project practice question was about nursing staff in long-term care …

Organization Change Process Evaluation Improving Phq-9 Completion Following Positive Phq-2 Screenings In An Outpatient Behavioral Health Setting, Diana Pieterson

Walden Dissertations and Doctoral Studies

Depression is a leading cause of disability worldwide and is associated with significant impairment, delayed treatment, and increased suicide risk when not appropriately identified and managed. In an outpatient behavioral health setting, review of de-identified electronic health record (EHR) data identified inconsistent completion of the Patient Health Questionnaire-9 (PHQ-9) following positive Patient Health Questionnaire-2 (PHQ-2) screenings, resulting in incomplete depression assessment and missed opportunities for timely intervention. This Doctor of Nursing Practice (DNP) project evaluated whether implementation of a standardized PHQ-2 to PHQ-9 workflow improved PHQ-9 completion rates among adult outpatients with positive PHQ-2 screenings. The organization change process included …

Staff Education On Psychoeducation Delivery To Enhance Medication-Adherence Education For Adults With Bipolar Disorder In An Outpatient Psychiatric Mental Health Facility, Bibiana Chinwe Ndula

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed inconsistent delivery of evidence-based medication-adherence psychoeducation for adults with bipolar disorder (BD) in an outpatient psychiatric mental health facility. The project question was whether an 8-week structured module, in relation to existing staff education practices, would increase staff knowledge and confidence. The intervention was guided by the Johns Hopkins evidence-based practice (JHEBP) model and comprised a PowerPoint presentation, a facilitator guide, a handout, a checklist, a toolkit, and anonymous pre- and post-training assessments. Eight out of ten invited staff completed the project. The mean knowledge rose from 6.1 to 8.9 …

Staff Education To Standardize Chronic Pain Patient Education In Primary Care, Jessica Okpara

Walden Dissertations and Doctoral Studies

Inconsistent delivery and documentation of chronic pain patient education may contribute to variations in patient knowledge, treatment expectations, and engagement in self-management. This Doctor of Nursing Practice staff education and quality improvement project was designed to standardize chronic pain patient education in a primary care setting. The practice-focused question examined whether implementing standardized chronic pain education, compared with non-standardized education, would improve patient knowledge and use of self-management strategies over 10 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model, the project included development of evidence-based education materials, staff preparation, workflow integration, and a standardized documentation process. Clinic staff identified …

Reducing Medication Administration Errors Through Implementation Of An Electronic Medication Administration Safety Dashboard, Myrlande Daguindeau

Walden Dissertations and Doctoral Studies

The DNP project was a quality improvement (QI) initiative designed to reduce medication administration errors by integrating an electronic medication administration safety dashboard (BCMA) at Sheppard Pratt Hospital in Elkridge, Maryland. The purpose of the project was to evaluate the effectiveness of a medication safety dashboard in providing automated clinical alerts to improve real-time monitoring and support safer medication administration practices. The project was informed by the prevalence of medication administration errors in the psychiatric unit attributed to factors such as frequent adjustments of medication and interruptions during the medication administration process. Data were collected from the hospital’s records and …

Improving Glycemic Control And Self-Care Among Adult Patients With Type 2 Diabetes Mellitus At A Community Health Center, Lydia Asabea Lartey

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a significant practice concern in community health settings, where adults often encounter barriers to effective self-management, including low health literacy, socioeconomic challenges, and limited access to Diabetes Self-Management Education and Support (DSMES). At the project site, inconsistent staff preparation, high patient volume, and limited standardized teaching resources contributed to gaps between evidence-based standards and routine diabetes education. To address these gaps, the project implemented a standardized, culturally responsive diabetes-education workflow to strengthen care quality, patient safety, and responsible resource use. The practice question guiding the project was: How does implementing a standardized, culturally responsive …

Staff Education To Improve Knowledge And Confidence In A1c Screening For Adults With Serious Mental Illness, Veronica Akweley Odoi

Walden Dissertations and Doctoral Studies

This project was conducted to observe the effects of staff education on staff knowledge and confidence regarding metabolic risk and hemoglobin A1c (A1C) monitoring for adults with serious mental illness in a crisis response unit. The lack of a streamlined system in metabolic testing in recent times has led to nuances in metabolic testing for patients with serious mental illness. The practice-focused question asked whether evidence-based staff education on A1C monitoring, and provider roles would improve staff knowledge and confidence. The purpose of the education is to strengthen knowledge of metabolic risk, A1C screening expectations, role clarity, workflow, and staff …

Staff Education To Improve Depression Screening Adherence Using The Patient Health Questionnaire-2/Patient Health Questionnaire-9, Jeremiah Umeh

Walden Dissertations and Doctoral Studies

Depression is a common mental health condition that frequently goes undetected in primary care because of inconsistent screening and follow-up practices. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based staff education program to improve adherence to standardized depression screening using the Patient Health Questionnaire-2 (PHQ-2) and Patient Health Questionnaire-9 (PHQ-9) in a primary care clinic. Eighteen clinical staff members, including registered nurses, medical assistants, and primary care providers, participated in a structured educational intervention focused on standardized screening, documentation, scoring, and referral procedures. Project outcomes were evaluated using pre- …

Reducing Nurse Burnout, Oluwarotimi Tunde Aborisade

Walden Dissertations and Doctoral Studies

Nurse burnout is a severe job-related condition that significantly impacts nurses' well-being. Nurse burnout is a growing concern amid the increased demand for healthcare professionals. Research has been conducted to explore nurse burnout and how it affects the quality and safety of patients. Different research has also been conducted to review different interventions to address nurse burnout, including individual and organizational interventions. Some interventions include self-care, mindfulness and meditation, coping and resilience, as well as lifestyle adjustments. Some organizational interventions include workload management, psychological safety, and job redesign. This study was conducted to evaluate the effectiveness of individual interventions to …

Staff Education To Providers Prescribing Glp-1 Medications For The Treatment Of Obesity, Madeleine Williams

Walden Dissertations and Doctoral Studies

The utilization of glucagon-like peptide 1 (GLP-1) medications has skyrocketed over the past 5–8 years, with an average weight loss of 15–21% of initial weight. Unfortunately, not all providers offer evidence-based patient education when starting a GLP-1 medication for the treatment of obesity. A practice gap I have identified is the lack of consistent evidence-based education providers utilize when prescribing GLP-1 for obesity treatment in the primary care setting. The project site was a hospital-based primary care clinic located in a suburban community in Washington. This staff education aimed to evaluate whether a standardized, evidence-based educational tool on GLP-1 medications …

Implementation Of A Nightshift Sleep Promotion Bundle To Support Delirium Prevention In A Neurosurgical Intensive Care Unit, Pamella Simpson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project aimed to identify the need for a consistent sleep-promotion protocol in an adult neurosurgical intensive care unit (NSICU). Disrupted sleep is a frequent problem for patients who are seriously ill and can lead to delirium, longer hospital stays, higher health care expenses, diminished cognitive function, and death. While there was evidence supporting nonpharmacological sleep-promotion and delirium-risk-reduction interventions, they were not consistently implemented at the project site, creating a gap between evidence and clinical practice. The purpose of this project was to implement and evaluate an evidence-based night-shift sleep-promotion bundle. The practice-focused …

Life Skills Counseling Services Needed For K-8 Self-Contained Students In Essex County, New Jersey, Faith Arianna Healy

Walden Dissertations and Doctoral Studies

Students in special education may experience a variety of barriers to gaining cohesive and consistent life skills training programs. A lack of life skills training for special education students may lead to a lack of social-emotional skills, social awareness, and an overall lack of independence once students have graduated. The purpose of this qualitative single case study was to explore the charter school human service professionals’ perceptions of the life skills counseling services needed for K-8 self-contained students in Essex County, NJ. Botvin Lifeskills Training program was used as the framework for the study. Using a qualitative research model, semistructured …

Hypnotherapists’ Perspectives On Using Hypnosis To Address Somatic Symptoms In Clients With Psychological Distress, Tina Wilkerson

Walden Dissertations and Doctoral Studies

Somatic symptoms accompany psychological distress and can affect well-being. Hypnosis has demonstrated effectiveness in reducing psychological distress and related somatic symptoms, but limited research has explored hypnotherapists’ perspectives on its clinical application. The purpose of this qualitative phenomenological study was to explore the experiences of licensed hypnotherapists with 3 years of experience using hypnosis to treat adults experiencing somatic symptoms associated with psychological distress. Guided by Engel’s biopsychosocial model and Hilgard’s neodissociation theory, data were collected through semistructured interviews with 10 licensed hypnotherapists and analyzed using phenomenological reduction and thematic analysis. Analysis resulted in four primary themes: (a) mind–body connection …

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …

Exploring The Lived Experiences Of African American Couples: Narcissism, Marital Quality, And Spousal Distress, Lindella Lenise Mcdowell

Walden Dissertations and Doctoral Studies

Narcissism is a global phenomenon that is manifested across cultures. Despite research on narcissism and relationships, there is limited literature focusing on diverse cultural backgrounds, particularly African American couples, where one spouse has been diagnosed as exhibiting narcissistic tendencies or traits. Addressing the research gap may foster cultural understanding and encourage recognition of the effects of narcissism within the African American culture and the significance of social support. The purpose of this study was to increase knowledge and awareness of grandiose and vulnerable narcissism’s impact on African American couples. A qualitative phenomenological research design was used. The hierarchical two-dimensional view …

Improving Identification And Initial Management Of Perimenopause In Primary Care, Yewande Banire

Walden Dissertations and Doctoral Studies

Perimenopause is a common but frequently underrecognized stage of reproductive aging that can significantly affect women's physical, psychological, cognitive, and sexual well-being. In primary care, inconsistent provider education and the absence of standardized screening and assessment processes often contribute to delayed recognition and fragmented management. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based clinical practice guideline to improve the identification and initial management of perimenopause in a primary care setting. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved synthesizing and critically appraising the literature to develop …

Educating Psychiatric Mental Health Nurse Practitioners On Long-Acting Injectable Antipsychotic Medication Management, Omonzua Mabel Eromosele

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed the underutilization of long-acting injectable (LAI) antipsychotic medications in an outpatient mental health center. Although LAI antipsychotics improve medication adherence, reduce relapse, and decrease psychiatric hospitalization, provider knowledge deficits and inconsistent prescribing practices lead to their underuse. The practice-focused question was: Among psychiatric-mental health nurse practitioners (PMHNPs) in an outpatient mental health center, what is the impact of an educational program on the application of LAI antipsychotic medication management on the improvement of staff knowledge? The purpose of this project was to implement and evaluate evidence-based educational intervention to improve …

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

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 …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …