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Implementing A Self-Administered Crafft Screening Tool In A Pediatric Mental Health Setting, Michael Nguyen

Doctoral Dissertations & Projects

Background: Adolescent substance use disorders (SUDs) require early identification in inpatient psychiatric settings, but inconsistent screening workflows limit systematic detection.

Aims: This quality improvement project evaluated implementation of the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) 2.1 screening tool to improve identification of adolescents at risk for SUDs and support multidisciplinary communication.

Methods: CRAFFT 2.1 screening was embedded into admission workflows for adolescents admitted to two inpatient psychiatric units. Admission nurses distributed self-administered forms during admission. Completed screenings were scored and entered into the electronic medical record. Scores were categorized as low (0), medium (1), or high (≥2). High-risk results …

Quality Improvement Project: Impact Of Faculty Competency And Classroom Application Of Artificial Intelligence (Ai), Clydea Hale

Doctor of Nursing Practice Projects

The rapid integration of artificial intelligence (AI) in healthcare has created a growing need for nursing faculty to develop competency in AI to adequately prepare students for modern clinical practice. Despite this need, limited faculty knowledge and low classroom application of AI persist. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of an evidence-based AI educational intervention on nursing faculty competency and classroom application. Guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory, a quasi-experimental pretest-posttest design was implemented with nursing faculty at a rural community college in …

Understanding Adult Patients’ Experiences Of Trauma-Informed Care In Outpatient Healthcare, Jayme Aguero

Dissertations (1934 -)

Trauma is recognized as a universal human experience. Well-established evidence demonstrates the negative impact of trauma on health outcomes. In 2014, following a recommendation from SAMHSA, trauma-informed care (TIC) was implemented across human service sectors, including healthcare. While TIC has been in use for the past decade, adults’ experiences of receiving TIC in outpatient healthcare remain largely unknown. The purposes of this study were (a) to explore and describe how adults’ healthcare experiences aligned with the principles of TIC being implemented in outpatient healthcare settings and (b) to understand the perceived usefulness and meaning of TIC for adult patients. A …

Quality Improvement Project: Improving Provider Workflow And Documentation For Routine Mental Health Screening In An Outpatient Psychiatric Clinic, Sharon Uchechi Joshua

Doctor of Nursing Practice Projects

Depression and anxiety are leading causes of disability and are frequently underdiagnosed in outpatient psychiatric settings due to inconsistent screening and documentation practices. Evidence supports the use of standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to improve early detection and clinical outcomes. This quality improvement (QI) project evaluated whether implementing standardized electronic health record (EHR) templates and provider education would improve documentation of PHQ-9 and GAD-7 screenings. The aim was to increase the consistency of screening and documentation among psychiatric providers. The project was guided by the Plan-Do-Study-Act (PDSA) framework and Lewin’s Change …

Embedding Social Determinants Of Health Into Maternal Simulation Scenarios: Enhancing Nursing Staff Awareness Of Equity-Based Education, Sherina Evans

Doctor of Nursing Practice Projects

Despite growing evidence emphasizing the importance in addressing disparities in maternal health outcomes, maternal health simulations often lack integration of social determinants of health (SDOH) and cultural considerations. The purpose of this Doctor of Nursing Practice quality improvement project was to enhance nursing faculty cultural awareness through simulation scenarios that incorporate SDOH and culturally responsive elements. This project was guided by Lewin’s Change Theory and the Jeffries Simulation Framework. The aim was to strengthen faculty awareness and skills to support the development of culturally inclusive simulation experiences. Descriptive statistics were utilized to analyze results which was a limitation. Nursing faculty …

Improving Monitoring And Documentation Of Long-Acting Injectable Antipsychotic Adherence In Patients With Schizophrenia Through Staff Education And Refill History Review, Stacy Ann Bruce

Doctor of Nursing Practice Projects

Schizophrenia is a chronic psychiatric disorder associated with relapse, hospitalization, and poor outcomes when medication adherence is suboptimal. Nonadherence increases morbidity and healthcare utilization (World Health Organization, 2022; Zhao et al., 2025). Long-acting injectable (LAI) antipsychotics improve adherence and reduce hospitalization, but inconsistent monitoring and documentation in outpatient settings hinder early identification of missed doses (Lieslehto et al., 2022). This Doctor of Nursing Practice (DNP) quality improvement project aimed to evaluate whether staff education and structured refill-monitoring processes improve identification and documentation of nonadherence to LAI antipsychotics. Using Kotter’s Change Management Model and the Plan-Do-Study-Act framework, the project focused on …

From Novice To Effective: Strengthening Clinical Education In Nursing, Stephanie Campbell

Doctor of Nursing Practice Projects

The professional transition from clinician to educator is often complicated by a lack of formal training and professional development. This gap in training and support compromises the delivery of nursing education and leads to feelings of inadequacy, diminished confidence, and higher rates of attrition. This quality improvement (QI) project seeks to improve the quality of clinical education by evaluating the impact of a structured onboarding process on a novice nurse educator’s self-efficacy and perceived support. Guided by Lewin’s Change Theory and Bandura’s Social Cognitive Theory, the project aims to enhance the onboarding process for novice nurse educators. The Find, Organize, …

Quality Improvement Project: Reimplementation Of Bedside Reporting, Veronicah Banga

Doctor of Nursing Practice Projects

Communication breakdown during nursing shift handoffs is a major patient safety challenge in healthcare today. At the project site, 85% of handovers occurred at the central nursing station, and most staff nurses expressed dissatisfaction with the quality of the bedside reporting. In psychiatric nursing, unique barriers exist that make bedside reporting challenging, including patient confidentiality and an individual's diagnosis. Such barriers eroded bedside reporting (BSR) over time, leading to measurable safety risks and nursing dissatisfaction. The purpose of this quality improvement project was to reintroduce bedside handoffs using the Situation, Background, Assessment, and Recommendation (SBAR) framework and to maintain BSR …

Fostering A Healthy Academic Environment In Nursing Education, Donna M. Hedges

Creating Healthy Work Environments (CHWE)

A healthy academic environment is foundational to the preparation of future nurses, the retention of faculty, and the overall success of nursing education programs. This presentation examines the multidimensional nature of a healthy academic environment, highlighting psychological safety, equity and inclusion, supportive infrastructure, academic integrity, and collaborative learning as critical elements. Drawing from relational-cultural theory and caring science, the presentation explores how these elements shape outcomes for students, faculty, and institutions. Common challenges—including incivility, limited resources, and faculty workload strain—are discussed alongside evidence-based strategies to foster resilience, collegiality, and organizational change. Implications for practice, policy, and research are identified, underscoring …

Exploring Leadership Strategies And Personnel Integration Practices During The Post- Merger Phase Influence The Success Of Mergers And Acquisitions, Rebekah Dumas

Walden Dissertations and Doctoral Studies

Mergers and acquisitions (M&A) have been widely used as a growth strategy; however, many organizations fail to achieve their desired outcomes. This ongoing risk is a major concern for business leaders because ineffective post-merger personnel integration can disrupt workforce stability, reduce productivity, and hinder organizational performance. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry project was to explore the strategies business leaders used to integrate personnel during post-merger transitions. Data were collected through semistructured interviews with eight business leaders from global corporations who had successfully executed mergers and acquisitions, along with a review of publicly available …

Exploring The Experiences Of Faculty Members Educating Students Virtually Post-Covid-19, Raven Ashley Richardson

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic significantly disrupted higher education, requiring institutions to rapidly transition to virtual learning environments and leaving faculty to manage increased workloads, stress, and challenges related to instructional quality and student engagement. The problem in this study is traditional faculty continue to experience these challenges in the post pandemic academic landscape, with implications for faculty wellbeing and student success. The purpose of this qualitative generic study was to explore experiences of traditional college faculty members educating students while transitioning from in-person to virtual learning environments post-COVID-19. Guided by the ecological systems theory, multilevel influences on faculty experiences were examined. …

It Strategies Used To Implement Enterprise Resource Planning Systems, Michele Doverspike

Walden Dissertations and Doctoral Studies

Enterprise resource planning (ERP) system implementation represents a significant challenge for small businesses, with failure rates that can lead to substantial financial losses and operational disruption. Information Technology (IT) managers in small businesses face a gap in evidence-based strategies tailored to their organizational context, increasing the risk of implementation failure and its associated financial and operational consequences. Grounded in general systems theory, the purpose of this qualitative multicase study was to explore the strategies IT managers use to implement ERP systems in small businesses in central Pennsylvania. The participants were six IT managers from small businesses in Pennsylvania who had …

Effective Small Business Leadership Strategies Used In Rural Areas To Optimize Employee Retention, Michelle Lynn Cathey

Walden Dissertations and Doctoral Studies

Employee retention remains a persistent challenge for rural small business leaders. The specific business problem addressed in this study was that some rural small business leaders lack effective leadership strategies to retain employees, which threatens organizational sustainability and workforce stability in rural communities. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective leadership strategies used by rural small business leaders in Northeast California to optimize employee retention. Data were collected from semistructured interviews with six rural small business leaders in Northeast California and were triangulated with publicly available documents, websites, and …

Centralizing Communication Intake To Improve Workflow Visibility And Engagement: A Quality Improvement Project In A Cancer Center's Education Division, Menatalla El-Sharkawi, Mohamed Ait Aiss

Advances in Cancer Education and Quality Improvement

Background: In large or complex organizations, multiple teams may be charged with managing different components of a project, initiative, or administrative assignment. When these teams have overlapping needs for information, the absence of a structured intake and tracking process can limit transparency, reduce efficiency, and hinder coordination across communication channels.

Methods: Drawing on principles of strategic communications and project management, we created a structured and centralized information sharing process for teams within the education division of a comprehensive cancer center. The intervention included workflow redesign, development of a standardized intake system, and use of real-time dashboard analytics to support operation …

Leadership Strategies To Reduce Burnout Among Physicians In Academic Medical Centers In The State Of California, Navdip Kaur Hothi

Walden Dissertations and Doctoral Studies

Physician burnout in academic medical centers remains a persistent healthcare administration challenge, with nearly half of U.S. physicians reporting symptoms of burnout in recent years. The issue threatens workforce sustainability, patient safety, and organizational financial stability, particularly in California’s academic medical centers, were physicians face complex clinical, academic, and operational demands. The integrative review examines leadership strategies that reduce physician burnout in California’s academic medical centers, aiming to lower rates from about 45% to under 30%. Transformational Leadership Theory guided the examination of leadership-driven organizational and system level approaches to burnout reduction. Twenty-seven sources were appraised using the Johns Hopkins …

The Relationship Between Leadership Communication Strategies And Employee Productivity, Motivation, And Engagement, Christopher Tucker

Walden Dissertations and Doctoral Studies

Business leaders are concerned that change leaders’ communication strategy impacts organizational productivity and performance. These challenges can be attributed to business leaders and human resources managers not understanding the relationship between employee motivation, engagement, productivity, and leaders’ communication strategy. Grounded in the composite conceptual framework of Kotter’s eight-step model for change and the Burke-Litwin causal model of organizational performance, the purpose of this quantitative correlational project was to examine the relationship between employee’s motivation, engagement, productivity, and leaders’ communication strategy. The participants were 77 human resources professionals in the United States with at least 5 years of experience in their …

Principal Coaching Impact: Elementary Principals' Perspectives On Their Coaching Experience, Kyle L. Hoopes

Theses and Dissertations

School principals face increasing complexity as they navigate instructional leadership, organizational change, and the emotional demands of supporting staff and students. Traditional professional development--often episodic and compliance-driven--has proven insufficient for helping principals translate knowledge into practice. This qualitative phenomenological study examined how 20 elementary principals in a large intermountain district experienced a dual-coach, team-based leadership coaching model and how coaching influenced their leadership practices and well-being. Semi-structured interviews and iterative thematic analysis revealed that coaching shaped three core areas of leadership practice: gaining clarity and direction, prioritizing instructional and organizational goals, and strengthening collaboration within school leadership teams. Principals also …

Highly Skilled First-Generation Immigrant Kenyan Women’S Lived Experiences With Workplace Integration Strategies In California, Lily Quiette Otieno

Walden Dissertations and Doctoral Studies

Unlocking the potential of highly skilled first-generation immigrant women in the workplace is critical in an era of globalization and multiculturalism. The social problem is that organizations face challenges integrating highly skilled first-generation immigrant women into the U.S. workforce due to a limited understanding of effective workplace integration strategies. The purpose of this qualitative phenomenological study was to explore the lived experiences of highly skilled first-generation Kenyan women with workplace integration strategies in California. The study was grounded in Graen and Uhl-Bien’s leader-member exchange theory and Crenshaw’s intersectionality theory to understand how leadership relationships and intersecting identities shaped workplace experiences. …

Exploring Leadership Barriers To Patient Experience Improvement In The Acute Care Hospital Setting, James Scott Cooper

Walden Dissertations and Doctoral Studies

Resistance to patient experience initiatives remains a persistent challenge in acute care hospitals, often undermining organizational efforts to improve engagement, culture, and care delivery despite broad acknowledgment of their importance. Healthcare leaders need to understand this challenge as a primary indicator affecting patient experience outcomes. The purpose of this qualitative narrative inquiry was to explore the factors that cause resistance to change faced by patient experience leaders (PELs) in the acute care hospital setting. The theory of planned behavior grounded this study. The participants consisted of 15 PELs working in acute care hospitals across the United States. Data were collected …

Examining Automated Writing Evaluation Error Coverage In Relation To Uptake And Retention, Mohaddeseh Mehrzad, Mohammad Rahimi, Stephanie Link

Journal of Response to Writing

Despite the current widespread use of Automated Writing Evaluation (AWE) feedback, many issues regarding its efficacy still remain unresolved. Recent studies mainly focus on correctly detected errors with a lack of attention on the comprehensiveness of error detection, or error coverage. Error coverage is interesting because little is known about the capacity of AWE systems to fully detect common second language (L2) errors. It is also important to investigate the potential effect of such capacity on student uptake and retention, which are important constructs in fostering L2 writing development. To this end, the present study compared teacher feedback and AWE …

Quality Improvement Project: Improving The Clinical Teaching Experience Through Clinical Adjunct Orientation, Elissa Saunders

Doctor of Nursing Practice Projects

Clinical adjunct nursing faculty often transition into academic roles without formal preparation, leading to role insecurity and high turnover rates that negatively impact student clinical experiences. The purpose of this quality improvement (QI) project was to implement a structured orientation checklist to improve perceived clinical teaching competency among novice clinical adjunct faculty. The project aimed to standardize onboarding and support the transition from clinical practice to academia. A quantitative pre-post intervention design was used with a convenience sample of clinical adjunct faculty employed for less than one year at a rural university nursing program. The project was guided by Kotter’s …

Strengthening Evaluation For Student Success, Hollan Scrivner

Doctor of Nursing Practice Projects

Student evaluation is an important factor in guiding students to develop self-confidence and gain competency in nursing skills. For evaluation to be effective, it must be consistent. The purpose of this quality improvement project is to implement a training program to improve consistency and interrater reliability among faculty conducting skill evaluations. The impact of the training program will be measured by a pre- and post-grading exercise using a skills rubric. Data will be extracted from the rubrics and entered into a codebook for data analysis. The project was guided by the theoretical framework of Stephens’ Star Model of Knowledge Transformation …

Quality Improvement Project: The Impact Of The Clinical Judgment Measurement Model In Nursing Faculty, Lamia Zeidan

Doctor of Nursing Practice Projects

Clinical judgment is essential for nursing practice and can be taught using the Clinical Judgment Measurement Model (CJMM). A needs assessment conducted at the project site revealed that students had limited clinical judgment skills, there was no emphasis on clinical judgment in nursing skills courses, and the faculty had a limited understanding of the CJMM. In response to the findings of the needs assessment, the quality improvement (QI) project was developed using a quasi-experimental design. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Educator theoretical framework, the project aimed to provide faculty with education on the CJMM and …

Capital Projects As Catalysts For Strategic Change And Transformation In Higher Education, Lora Strigens

Dissertations (1934 -)

University campuses and their physical environments are a visible and symbolic representation of institutions. As the higher education landscape continues to shift and faces ongoing disruption, many institutions are considering significant strategic changes or broad transformation to remain competitive and thrive. As campuses around the country contend with aging buildings and infrastructure, they also have strategic priorities related to the changing needs and expectations of students, and the nature of teaching, learning, and research. Among these complex challenges, there is an opportunity to consider how institutions can leverage investment in the physical campus as a catalyst to support the strategic …

Effective Strategies Used By Small U.S. Technology Business Leaders To Reduce Turnover And Improve Productivity, Iesha Tyrie Hayes

Walden Dissertations and Doctoral Studies

High employee turnover in small U.S. technology firms undermines productivity and disrupts workforce stability. Small U.S. technology business leaders are concerned with employee turnover because persistent workforce attrition weakens operational continuity, increases organizational strain, and limits the ability to sustain a stable and effective workforce. Grounded in psychological capital (PsyCap) theory, this qualitative pragmatic inquiry was to explore leadership strategies used by small U.S. technology business leaders in North Carolina to mitigate negative employee experiences that contribute to turnover and reduced productivity. Data were collected using semistructured interviews and publicly available organizational documents. Using thematic analysis, three themes emerged: (a) …

Teachers' Perceived Impact Of Teacher-Led Committees On Agency And Morale, Sherry Wibben

Dissertations

The action research study examined how participation in teacher-led committees influenced teachers’ perceptions of agency and morale within an urban Midwestern high school. Grounded in theories of shared and distributed leadership, the study addressed a problem of practice centered on limited teacher voice, fragmented communication, and inconsistent collaborative structures. A convergent mixed-methods design was employed to evaluate changes in teacher morale and professional agency following implementation of teacher-led committees.

Quantitative data were collected using Wong’s (1991) Staff Morale Questionnaire (SMQ), measuring leadership synergy, cohesive pride, and personal challenge. Surveys were administered at baseline (N = 30) and endline ( …

Dynamic Capabilities For Transforming Governance In Open And Distance Learning University In Indonesia: Lesson From Salut Dgcn, Vivi Indra Amelia Nasution

Jurnal Pendidikan Humaniora

This study examines the transformation of governance in open and distance learning universities in Indonesia, focusing on the role of dynamic capabilities. The research highlights the experience of Universitas Terbuka (UT) and its learning center, SALUT (Sentra Layanan Universitas Terbuka), in utilizing dynamic capabilities to enhance the quality of education and services. The study adopts a qualitative approach with a single case study design, focusing on SALUT DGCN as one of the pioneering SALUTs of UT. SALUT DGCN's experience provides valuable insights into the practical application of dynamic capabilities in open and distance learning. Data collection involved in-depth interviews with …

Becoming Laser-Focused On Sustainability Leadership In Higher Education Institutions, Ray F. Coleman

Electronic Theses and Dissertations 2020 - Present

This dissertation explored leadership responses to integrating sustainability into higher education institutions (HEIs). Specifically, it compared statistical differences between self-perceptions of leadership and student, staff, and faculty perceptions regarding leadership effectiveness for sustainability in two Florida based HEIs: one holding a sustainability certification and one without such certification. In response to a shortage of survey instruments regarding this topic, I produced a new instrument to assess perceptions of leadership sustainability, made statistical comparisons between these two institutions to inform others of those perceptions, and synthesized several leadership components into a proposed change process identified as the Attitude Based Cognitive Dissonance …

Strategies Higher Education Leaders Use To Improve Job Satisfaction Among Administrative Staff, Jerrod Jaquii Pass

Walden Dissertations and Doctoral Studies

Organizational change initiatives in higher education often lead to decreased job satisfaction among administrative staff. Higher education leaders are concerned with maintaining employee job satisfaction during such periods because disengagement among administrative staff can reduce performance and increase turnover. The purpose of this qualitative pragmatic inquiry was to explore strategies higher education leaders use to improve administrative staff job satisfaction during organizational change. Lewin’s change management theory served as the foundation for the capstone research project. Data were collected through semistructured interviews with a purposive sample of six higher education leaders in the United States who had implemented change initiatives …

Implementation Of The Fourth Industrial Revolution Technologies In Tanzania’S Downstream Oil And Gas Industries, Vitalis John Mwinyi

Tanzania Journal of Engineering and Technology (TJET)

The advent of the fourth industrial revolution (IR4.0) has resulted in the digital transformation of multiple sectors of the economy due to the disruptive nature of the technologies driving the revolution. The technologies have already found their way into the oil and gas industries across the globe, especially in upstream, midstream, and downstream operations. However, the degree of implementation is not the same for these operations, considering the complexities involved, integrated process, the associated risk and investment cost, among others. This study aimed to establish the implementation level of IR4.0 technologies in the downstream operations. A survey method was employed …