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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This organization change process evaluation addressed continued reliance on outdated no-suicide and no-harm contracts in an outpatient psychiatric setting, despite evidence that such contracts do not reduce suicide risk and may create a false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 …

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 Enhance Phq-9 Depression Screening Compliance, Chibugo Chukwu

Walden Dissertations and Doctoral Studies

This staff education quality improvement project at Clinic P targeted the clinical problem of depression under-diagnosis, evidenced by less than 60% of patients completing the patient health questionnaire (PHQ-9) before the initiative. Depression under-diagnosis, significantly caused by provider PHQ-9 screening competency deficits that need to be addressed through staff education, is associated with adverse patient health outcomes, in turn generating negative implications for providers and wider society. The problem compromises the quality of nursing care because it limits nurses' ability to intervene and deliver timely and effective care to patients with depression. Thus, at Clinic P, this initiative asked how …

Staff Education To Address Verbal De-Escalation Skills In Correctional Mental Healthcare, Mary L. Goodman

Walden Dissertations and Doctoral Studies

This staff education project evaluated the effects of a structured verbal de-escalation training program on self-efficacy among staff in a federal correctional mental health unit. Staff at the site often reported uncertainty managing escalating behaviors, leading to frequent use of restrictive interventions like restraints and seclusion—practices that can compromise safety, quality of care, and raise ethical concerns. To address this gap, an evidence-based curriculum was implemented for 41 multidisciplinary staff, including nurses, certified nursing assistants, and correctional officers. The curriculum included a PowerPoint presentation, role play, and group discussion. A pre–post design measured changes in staff confidence using a modified …

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 …

K–3 Teachers’ Perspectives Regarding Learnable Intelligence As A Developmental Target And Their Advocacy For Students’ Cognitive Capabilities, Eleanor Nkechi Maduako

Walden Dissertations and Doctoral Studies

Extensive research shows the brain is malleable and, with experience and knowledge, intelligence can grow. The research problem addressed through this study was that the extent of early childhood educators' knowledge of learnable intelligence and their advocacy for advancement of children’s cognitive capabilities as a developmental goal were unknown. Guided by Perkins’s theory of learnable intelligence, the purpose of this basic qualitative study was to explore K–3 teachers’ perspectives on learnable intelligence as a developmental target and how they advocate for children’s cognitive capabilities in their classrooms. In vivo and axial coding of data from semistructured interviews with 12 participants …

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 …

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 …

Staff Education To Reduce Foley Catheter Utilization In Patients With Acute Urinary Retention, Dennis Ulep

Walden Dissertations and Doctoral Studies

Acute urinary retention (AUR) is a common inpatient condition associated with complications such as urinary tract infections, prolonged hospitalization, and impaired mobility when not managed appropriately. Despite evidence supporting intermittent catheterization as a preferred first-line intervention for many patients with AUR, indwelling Foley catheters continue to be overused in acute care settings. Purpose: This Doctor of Nursing Practice (DNP) project evaluated whether staff education on a standardized AUR algorithm would improve evidence-based urinary retention management and reduce unnecessary Foley catheter utilization among nurses caring for adult hospitalized patients on a hematology and oncology unit in a Southern California acute care …

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 …

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 …

Standardizing Interfacility Transfer In And Out Processes Across The Local Va Setting, Petrice Robinson Brown

Walden Dissertations and Doctoral Studies

The quality improvement project focused on the inconsistent documentation and communication of the transfer of veterans in and out of a Veterans Affairs Medical Center. Lack of transparency in handoff knowledge and ineffective documents posed a risk of delayed care and patient injuries. The staff provided an audit tool with staff education to monitor completion of mandatory transfer steps, such as special mode travel approval, equipment needs, nurse-to-nurse handoff, transfer notes, consent, and physician correspondence. This method was based on the evidence found in literature indicating that structured checklists and handoff tools minimize missed information and facilitate safer care transitions …

Age Reassignment Using Luminescence Dating For The Mammoth Site, Black Hills, South Dakota, Usa, Shannon A. Mahan, Jim I. Mead, P.R. Hanson, Emma T. Krolczyk, Christopher N. Jass

School of Natural Resources: Faculty Publications

The Mammoth Site (MS) at Hot Springs, South Dakota, provides a unique opportunity to reconstruct paleoenvironmental conditions on the Northern Great Plains of the United States. Previous radiocarbon analyses of mammoth bone apatite suggested the MS sinkhole was deposited ∼42–23 cal ka BP. However, two U-series ages and one thermoluminescence (TL) age ranged between 150 and 101 ka, suggesting the bones were considerably older. We analyzed six samples from the bone bed using infrared-stimulated luminescence (IRSL) on feldspars, because the quartz luminescence was saturated; the ages ranged from approximately 232 to 160 ka, showing better agreement with previous U-series and …

Stemless Arthroplasty For Avascular Necrosis Of The Humerus: Implant Survival And Outcomes, Alyssa R. Henriquez, Damon V. Briggs, Eoghan T. Hurley, Samuel Lorentz, Christopher S. Klifto, Michael A. Moverman, Oke Anakwenze

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Avascular necrosis (AVN) of the humeral head often affects younger patients and may lead to progressive pain and functional deficits. While stemmed hemiarthroplasty and total shoulder arthroplasty (TSA) are established treatments for advanced-stage AVN, stemless arthroplasty offers potential advantages including bone preservation and facilitation of future revision. However, the impact of bone necrosis on stemless humerus fixation is yet to be elucidated. Therefore, the purpose of this study was to evaluate the outcomes of stemless hemiarthroplasty and TSA in treating humeral head AVN and, further, to determine if stemless humeral fixation is appropriate in this population.

METHODS: This retrospective …

Belonging And Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia Hickman

Papers

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

Predictive Factors For Humeral And Ulnar Stem Loosening After Total Elbow Arthroplasty: A Retrospective Cohort Study, Akash Singh, James Satalich, Miguel Fiandeiro, Harrison S. Fellheimer, Matthew Ramsey, Surena Namdari

Rothman Institute Conference Posters

BACKGROUND: There has been a significant increase in the use of total elbow arthroplasty (TEA) in advanced osteoarthritis, post-traumatic arthritis, and complex distal humerus fractures. The purpose of this study is to determine the incidence of total elbow loosening and association with patient demographics, implant specifications, and cement mantle characteristics.

METHODS: A retrospective cohort study was conducted of patients who underwent primary TEA between 2013 and 2022 at a single institution. Revisions and conversions from prior open reduction and internal fixation were excluded. Pre-operative distal humeral cortical thickness and bone quality were assessed. Variables included anterior humeral flange contact with …

Power Play: The Ftc, Non-Compete Bans, And The Argument For Statutory Authority, Jonathan M. Huelsman

University of Dayton Law Review

No abstract provided.

Identifying The Brain Circuits Involved In Religious Obsessive-Compulsive Disorder, Kiana Bunnell

Theses and Dissertations

Obsessive-compulsive disorder (OCD) is an often-debilitating psychiatric disorder involving a pattern of obsessive thoughts and compensatory compulsions. Symptoms tend to be chronic, leading to substantial emotional burden and significant impairment across multiple domains of daily functioning. Previous research has identified some consistency in the brain regions implicated in OCD. In particular, cortico-striato-thalamo-cortical (CSTC) circuitry has been linked to behavioral features commonly observed in OCD. Moreover, some studies suggest that distinct patterns of brain activation and functional connectivity may be associated with different OCD symptom dimensions, though findings have not been consistent. One symptom dimension of OCD (scrupulosity) is characterized by …

Is “No Change” Really No Change?: A Qualitative Analysis Of Clients With “No Change” On Routine Outcome Monitoring Who Report Improving In Therapy, Audrey Louise Stewart Parker

Theses and Dissertations

Routine outcome monitoring (ROM), the practice of tracking client progress in therapy by administering regular questionnaires to assess functioning, has demonstrated a significant positive effect on psychotherapy outcomes, especially for clients are who not improving as expected. However, some researchers argue the symptom-based measures and outcome classification criteria commonly used in ROM may not represent a complete picture of client change. A recent body of mixed-methods research has investigated these ROM-determined outcome categories to gain insight into client experiences and whether the category and client perception of therapy outcome align. In this investigation, researchers have found significant variety within outcome …

The Lived Experience Of Running Among Individuals With Anxiety, Emily Rice

Walden Dissertations and Doctoral Studies

Anxiety is among the most prevalent mental health concerns affecting adults, yet many individuals encounter barriers to traditional mindfulness-based interventions. Running is frequently described as promoting presence, mental clarity, emotional grounding, and relief from anxiety-related distress; however, little qualitative research has explored how adults with anxiety make meaning of their lived experiences of running. The purpose of this interpretative phenomenological analysis (IPA) study was to explore how adults with anxiety describe and make meaning of their lived experiences of running. Guided by embodied cognition and informed by mindfulness and flow theories, this study explored participants' lived experiences of running. Participants …

Comparison Of Training Background And Characteristics Between Osteopathic And Allopathic Team Physicians In Professional Sports Leagues., Brandon D Rust, Ambika Singh, Matthew T Mckinley, Joseph Imler, Mackenzie Elting, Ryan Callahan, Christopher L Rennie, Leighann C Krasney

Orthopedic Surgery Resident Research

CONTEXT: Team physicians (TPs) play a critical role in professional sports, providing medical care for athletes under high-pressure conditions. These positions are highly competitive, influenced by previous affiliations, training pedigree, and institutional connections, with fellowship training increasingly essential. Although the number of osteopathic (Doctor of Osteopathic Medicine [DO]) physicians in the United States has grown substantially, TPs in professional sports remain predominantly filled by allopathic (Doctor of Medicine [MD]) physicians, and the training pathways of DO TPs are not well characterized.

OBJECTIVES: The objective of this study is to compare the training and demographic characteristics of DO and MD TPs …

What Do Children Think About Bouncy Bands: A Mixed Methods Examination Of Bouncy Bands' Influence On Attention And Physical Activity, Ken Murfay, Sarah Collins

International Journal of Physical Activity and Health

Purpose: To examine how bouncy bands put onto elementary students’ classroom desks influenced students’ physical activity and attention/concentration, in addition to exploring students’/teachers’ opinions of the bands. Methods: Students within both experimental and control groups wore pedometers to assess movement during instruction and completed the d2 test for attention. Results: The group with bouncy bands on the desks had significantly more movement compared to the control group. For d2 scores, there was no significant difference between the two groups, nor was there a significant linear relationship between movement and d2 scores. Interviews were conducted with the students in the experimental …

Dosimetric Comparison Of Hybrid 3d Conformal Radiation Therapy And Volumetric Modulated Arc Therapy Versus Vmat-Only Planning For Accelerated Partial Breast Irradiation, Erjona Jusufi

Masters Projects

Abstract

Purpose: To compare dosimetric outcomes between volumetric modulated arc therapy (VMAT)-only and hybrid VMAT plus three-dimensional conformal radiotherapy (3D-CRT) techniques for accelerated partial breast irradiation (APBI) in patients with early-stage left-sided breast cancer.

Methods and Materials: Thirty patients treated with APBI at a single institution were retrospectively replanned using both VMAT-only and hybrid (VMAT + 3D-CRT) techniques. All plans were prescribed 26 Gy in 5 fractions. Each patient was planned using the same target volumes, optimization objectives, and evaluation criteria for both techniques. Planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), hotspot control, organ-at-risk (OAR) doses, …

Info 7001: Technology Of Information, S E. Hackney

Open Educational Resources

BULLETIN DESCRIPTION INFO 7001. The Technology of Information. 3 hr.; 3cr. The course will introduce the conceptual and practical elements of visual and computer literacy for the library and information science profession. Particular attention will be paid to libraries and information centers.

EXPANDED COURSE DESCRIPTION The evolution into the age of information has created a requirement that professional librarians establish and steadily increase their understanding of four areas of literacy: oral, print, visual, and technology. Professional training has long been concentrated on the oral and printed aspects of information with some minor attention to the visual and technological. Library and …

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 …

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 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 …

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 …

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 …