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Implementation Of A Fall-Prevention Clinical Practice Guideline In A Neurological Rehabilitation Center, Ron L. Adolph

Walden Dissertations and Doctoral Studies

This executive summary presents the final plan for implementation of an evidence-based fall-prevention clinical practice guideline on an open neurological rehabilitation unit. It does not propose a new device, a new electronic platform, or a separate education-only initiative. The practice change is the implementation and evaluation of a structured interdisciplinary clinical practice guideline designed to reduce inpatient falls and improve the reliability of daily prevention practices. The unit reports a baseline fall rate of 6.3 falls per 1,000 patient days. Thirty-five staff members from nursing, therapy, and support roles completed the survey, and 57% reported that patients had experienced falls …

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

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 …

Lived Experience Of Secondary School Teachers During The Covid-19 Pandemic, Diane R. Lovett

Walden Dissertations and Doctoral Studies

The study emphasizes the need for a deeper understanding of secondary school teachers' experiences during the COVID-19 pandemic, particularly focusing on their challenges during the transition back to in-person instruction after teaching online. The purpose of this phenomenological study explored the experiences of U.S. secondary teachers during the onset of COVID-19, the shift to virtual teaching, and the return to in-person instruction. The study was grounded in Bandura’s (1986) social cognitive theory, specifically the concept of observational learning and self-efficacy, to understand how teachers learned from peer successes and challenges during the transition to virtual learning and when returning to …

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 …

Executive Summary On Prolonged Emergency Department Waiting Period, Peace Adaugo Ezirim

Walden Dissertations and Doctoral Studies

Emergency departments (EDs) are essential access points to healthcare for patients with urgent and emergent conditions. Yet, many EDs face persistent challenges, including overcrowding, prolonged wait times, and delays in care. These challenges can significantly affect patient safety, quality of care, and overall healthcare outcomes. Patients presenting with symptoms, such as cardiac, pulmonary, or abdominal discomfort, may initially appear clinically stable, but their conditions can deteriorate rapidly while awaiting evaluation by a provider. Without structured reassessment processes and efficient communication systems, early warning signs of clinical decline may be missed. ED crowding has become a widespread operational and patient safety …

Staff Education On Evidence-Based Weight Management Strategies For Adults With Mental Health Disorders And Type Ii Diabetes Mellitus, Abimbola Oluwafunmilayo Somoye

Walden Dissertations and Doctoral Studies

Summary The type of project is a staff education project, specifically on evidence-based weight loss strategies that the facility can use to manage adults with type 2 diabetes mellitus (T2DM) and co-morbid mental health disorder(s). The evidence-based practice (EBP) question is: Does educating staff on weight loss strategies for T2DM with mental health disorder(s) improve staff knowledge and confidence within one month of staff education program implementation? The facility’s staff managed these patients using standardized diabetes management practices and have no formal staff education program that focuses on evidence-based weight loss strategies for this population. The staff has a vast …

The Impact Of Sexual Harassment Policy Strictness And Supervisory Support On Reporting Behavior In Local, County, And State Female Law Enforcement Officers In Northeastern Kansas, Cleora Maxine Tousey

Walden Dissertations and Doctoral Studies

This quantitative study examined the impact of stricter sexual harassment policies with protections against retaliation and stronger supervisory support on the likelihood that female law enforcement officers would report incidents of sexual harassment by male colleagues. The problem addressed was the underreporting of sexual harassment in policing, a critical issue given the negative impact on victims and workplace culture. Connell’s theory of masculinity served as the theoretical framework, indicating how traditional power dynamics may negatively influence the likelihood of reporting. Using a correlational design, this study surveyed municipal, county, and state female officers in Northeastern Kansas to measure their perceptions …

The Relative Strength Of Justice-Related Satisfaction, Posttraumatic Maladaptive Beliefs, And Self-Compassion In Predicting Perceived Control Over Stressful Events, Katherine Mooney

Walden Dissertations and Doctoral Studies

Coercive control and domestic violence perpetrated by men against women are global social problems sustained by patriarchal norms that normalize gender-based violence. These norms often contribute to victims' maladaptive self-beliefs, leading women to believe they provoked the abuse. When survivors seek legal protection, they may experience revictimization through legal processes that minimize their claims and enable perpetrators to continue exerting power and control through the justice system. As a result, dissatisfaction with the legal system may reinforce self-blame, while low self-compassion may further undermine women's perceived control over stressful events in both the short and long term. While previous research …

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 …

Effective Leadership Strategies For Sustaining Radiology Departments During And After The Covid-19 Pandemic, Tameron Shanay Reed

Walden Dissertations and Doctoral Studies

Pandemic-driven workforce challenges highlighted the urgent need for radiology leaders to retain skilled staff and sustain service delivery. The COVID-19 pandemic raised considerable concerns for radiology leaders regarding future preparedness for patient safety, care outcomes, hospital expenses, and hospital profitability. Grounded in the Vroom expectancy theory, the purpose of this qualitative pragmatic inquiry was to explore successful strategies radiology department leaders used to retain employees, improve supply inventory management, and develop ambulatory and virtual services during and after the COVID-19 pandemic. Data were gathered through semistructured interviews with six successful radiology leaders and publicly accessible documents in northern Louisiana. The …

Staff Education On Medication Nonadherence In Primary Care Clinic, Priscillia Adaugo Obasi

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a staff education initiative designed to address the practice problem of a lack of evidence-based approaches to patient education on medication compliance in a primary care clinic. A literature search was conducted using PubMed, CINAHL, MEDLINE, and the Cochrane Library search engines/databases, revealing nine studies that supported the premise that patient education can promote medication compliance. A practice-focused question underpinning this project was: Will staff education on evidence-based methods for educating patients about the importance of medication adherence result in increased staff knowledge? Baseline staff knowledge and educational needs were obtained using …

Placement Scores As A Predictor Of Math Success For Students With Learning Disabilities, Latosha Knighton Williams

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study was that students with learning disabilities (SWLDs) are not appropriately placed in college math courses at Southern State Community College (SSCC, a pseudonym). Guided by Piaget’s constructivist learning theory, the purpose of this quantitative study was to examine the predictive relationships between American College Testing (ACT), Postsecondary Education Readiness Test (PERT), and Scholastic Assessment Test (SAT) standardized placement exams math scores and Intermediate and College Algebra course success. The sample in this study consisted of 946 SWLDs who completed at least one standardized placement math exam and enrolled in either an Intermediate …

How Texas Early Childhood Teachers Collaborate To Support Students With Disabilities, Anna Weathers

Walden Dissertations and Doctoral Studies

The problem addressed in this study was it was not known how Texas early childhood special education (EGSE) teachers and early childhood general education (ECGE) teachers use collaboration to identify, place, and support students with disabilities (SWDs). Framed by Colby’s collaboration theory, the purpose of this basic qualitative study was to explore the experiences of Texas ECSE and ECGE teachers when collaborating regarding identification, placement, and support for SWDs. Data were collected in semstructured interviews with 11 ECSE and 11 ECGE teachers who taught in Texas early childhood settings. Data were analyzed using thematic analysis with open coding, leading to …

Training Strategies For Employees To Use Electronic Human Resource Management Systems, Anita Wright

Walden Dissertations and Doctoral Studies

Ineffective electronic human resource management (e-HRM) training can weaken HR employees’ ability to use digital human resource (HR) systems that support HR operations, employee services, and workplace efficiency. HR managers in small to medium-sized enterprises (SMEs) recognize that poor e-HRM training undermines employees’ confidence, consistency, and accuracy in HR tasks. Grounded in the technology acceptance model (TAM), the purpose of this qualitative pragmatic inquiry project was to identify and explore the effective strategies some SME HR managers use to train HR employees to use e-HRM systems. The participants were eight SME HR managers in the southeastern United States with experience …

Higher Education Instructors’ Perspectives On The Challenges Of Implementing Competency-Based Learning In Coursework, Sammie Leo Davis Jr

Walden Dissertations and Doctoral Studies

Higher education instructors face challenges in implementing competency-based learning (CBL) in their coursework. Grounded in Vygotsky’s social constructivist theory, the purpose of this basic qualitative study was to explore the perspectives of higher education instructors on the challenges and their needs to implement CBL in coursework. For this basic qualitative design, semistructured interviews were conducted with 12 higher education instructors who had at least 2 years of experience teaching CBL courses. Data were analyzed using qualitative content analysis and inductive coding to identify codes and categories, with the following five themes emerging: CBL implementation depends on (a) aligned assessment, curriculum …

Improving Pcu Nurses’ Knowledge Of Evidence-Based Mindfulness Techniques Through Targeted Education, Dairia Moore Mohammed

Walden Dissertations and Doctoral Studies

The progressive care unit (PCU) is a high-acuity setting in which nurses manage patients with complex health conditions, respond to rapid changes in clinical status, and navigate ongoing physical and emotional demands. The practice problem that I addressed was, presently, stress-management support is typically informal, optional, and reactive rather than systematic, evidence-based, and preventive. The purpose of this project was to implement and evaluate a structured educational intervention designed to increase nurses’ knowledge of evidence-based mindfulness breathing techniques that could be integrated into the daily PCU workflow. The practice-focused question was: In PCU nurses in an acute care setting, how …

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 …

A Comprehensive In-Silico Pipeline For The Discovery Of Non-Toxic, Stable Antimicrobial Peptides From Databases For Targeting Multi-Drug Resistant K. Pneumoniae, Pranab D. Sharma, Abdullah A. Noman, Al Hafiz

Faculty Articles

The rapid emergence of multidrug-resistant Klebsiella pneumoniae has significantly reduced the effectiveness of conventional antibiotics, highlighting the need for alternative therapeutic strategies. This study employed a comprehensive in silico pipeline to identify antimicrobial peptides (AMPs) targeting the essential DNA replication initiator protein DnaA. A total of 28,361 peptide sequences were collected from publicly available AMP databases and sequentially filtered based on peptide length, net charge, GRAVY score, instability index, antimicrobial activity, toxicity, hemolytic potential, aggregation propensity, sequence similarity and favorable amphipathic properties. Four peptides satisfied all selection criteria and were subjected to structural prediction, membrane-binding analysis, protein–DNA docking, protein–peptide docking, …

Predictors Of Adverse Events After Emergency Transfers In Long-Term Care: A Secondary Analysis, Yu-Chi Chen, Yi-Ru Liao

International Nursing Research Congress (INRC)

Long-term care residents worldwide frequently require emergency medical care due to multimorbidity, frailty, and functional impairment. After returning to long-term care facilities, many experience rapid health changes, leading to preventable adverse events, reduced care quality, and safety concerns. Identifying predictors of such events is essential to inform risk stratification and proactive nursing surveillance in long-term care settings. This study aimed to examine predictors of adverse events after emergency transfers, using Taiwan as a population-level case context.

A secondary data analysis was conducted using medical records from 19 long-term care facilities in northern Taiwan between October 2022 and September 2023. A …

Preventing The Next Tragedy: Applying Root Cause Analysis (Rca) In A Military Suicide Event, Li-Ling Lin, Kai-Wen Li, Yun-Shih Lin

International Nursing Research Congress (INRC)

This study examines a near-miss suicide by a high-risk military patient in an acute psychiatric ward. Using Root Cause Analysis (RCA), latent errors in system design and communication were identified, guiding strategies to enhance patient safety and care quality.

Objective: The purpose of this study was to implement RCA in a military suicide event and improve the process of care in an acute psychiatric ward.

Methods: The RCA process involves identifying the problem, establishing a timeline, identifying the causes, creating a cause-and-effect diagram, and implementing strategies. We conducted personnel interviews and on-site walk to understand the operations and environment, reconstructing …

Gloves On Or Off? A Critical Ethnographic Study Exploring Non-Sterile Glove Use In Hospital Settings, Navisha Weerasinghe, Fiona A. Miller, Lisa Cranley, Quinn Grundy

International Nursing Research Congress (INRC)

Globally, the COVID-19 pandemic sparked a surge in the production and use of plastic single-use medical products, particularly single-use gowns, masks, and gloves. The proliferation of single-use medical products in care work highlights significant tensions between safety, cost, infection prevention and control (IPAC), and environmental concerns. Nurses are critical stakeholders in driving environmental sustainability within health systems as they are uniquely positioned at the intersection of patient care, supply utilization, IPAC, and waste generation. In recent years, ‘gloves-off’ campaigns have been introduced at some hospitals globally and in Ontario to attend to the environmental harms associated with unnecessary glove use. …

Lymphatic Massage For Reducing Upper-Limb Edema In Icu Patients: A Quality Improvement Project, Ying-Fang Huang, Tzu-Ting Huang

International Nursing Research Congress (INRC)

Purpose: Upper-limb edema commonly occurs among critically ill patients due to immobility, inflammation, and fluid overload, leading to discomfort, impaired mobility, and higher pressure injury risk. Based on lymphatic physiology and prior evidence, this quality improvement (QI) project aimed to reduce edema severity through a structured nurse-led lymphatic massage intervention in the medical intensive care unit (MICU) of a northern Taiwan medical center.

Methods: This QI project was conducted from March to May 2025 using the Plan–Do–Check–Act framework. Baseline audit showed that 75% of patients had moderate to severe edema (≥ +2). Twenty adult patients were enrolled—10 in the intervention …

Impact Of Electronic Health Records On Nursing In Low-And Middle-Income Countries: A Scoping Review, Wahab Osman, Kimberley Widger, Alexandra Harris, Vida N. Yakong, Charlene Chu, Stephanie Asah-Ofori

International Nursing Research Congress (INRC)

Background: Electronic health records (EHR) are increasingly being implemented in low- and middle-income countries (LMIC), a significant shift from paper-based documentation, with goals to enhance clinical decision-making (1-5). However, implementation challenges such as lack of technical skills, funding constraints, and equipment issues exist (2-4). Furthermore, there is a lack of research focused on the impact of EHR implementation on nurses in LMIC, despite the critical role of nursing documentation on care decisions and planning (1-5).

Aims: To map evidence and identify research gaps from primary studies on the impact of electronic health records on nursing care in LMIC from 2015 …

Characterizing Stigma In Congenital Heart Disease: A Scoping Review, Tieghan Killackey, Valerie Tan, Mark Sochaniwskyj, Maryjo Antonio, Mohit Prashar, Ashley Farrell

International Nursing Research Congress (INRC)

Congenital heart disease (CHD) is the most common congenital malformation in Canada with a prevalence of 1.3%. (1) While medical advancements have improved survival rates, individuals with CHD have reported experiencing social exclusion, isolation, discrimination and bullying due to their condition, which impacts their social, professional, and emotional well-being.(2,3) This type of stigmatization can impact mental health, treatment adherence, and quality of life in patients (4); however limited research has focused on the experience of stigma in patients with CHD.

The purpose of the scoping review is to synthesize evidence on the various manifestations of stigma in the lives of …

Male Partners' Experiences During Their Spouses' Menopausal Transition, Veronica Adwoa Agyare, Martha Yawa Benti, Martha Atiemo

International Nursing Research Congress (INRC)

Background: Menopause involves a range of physical, emotional, behavioural and physiological changes that may affect the quality of life of women and their partners. Usually, men endure in silence and seem invisible. Evidence shows a dearth of literature on men’s perspectives regarding their spouses’ menopause in Sub-Saharan Africa (Zhang et al., 2020; Matina et al., 2025). The study explored Ghanaian men’s experiences during their spouses menopausal transition.

Method: The study utilised an exploratory, descriptive qualitative approach to understand the phenomenon. Thirteen men living with wives experiencing menopause involved in the study based on information power. Interviews were conducted face-to-face and …

Predictors Of Choking In People With Schizophrenia In A Psychiatric Hospital: A Case-Control Study, Ying-Jyun Tsung, Chiu-Yueh Yang

International Nursing Research Congress (INRC)

Background: Choking risks include advanced age, swallowing disorders, poor dental health, rapid eating, and large bites, especially in older adults and those with intellectual disabilities. Protective factors are adequate chewing and slower eating. More research is needed on psychiatric inpatients, especially those with schizophrenia.

Purpose: This study aimed to identify factors related to choking in psychiatric inpatients with schizophrenia.

Methods: A total of 250 participants were recruited from a psychiatric institution in Northern Taiwan. The case group comprised 50 high choking-risk participants, identified by a history of choking and a Choking Risk Assessment (CRA) score above 20 or a “Yes” …

Identification Of Positive Deviance In Forensic Nursing Practice, Jodie C. Gary, Laurie Charles, Jaeda Onyemobi

International Nursing Research Congress (INRC)

Violence is a sustained global public health issue.¹ Forensic nurses (FNs) receive specialized education to apply nursing knowledge and skills within the intersection of the healthcare and legal systems, focusing on people who experience or perpetrate violence, trauma, abuse, and maltreatment.² Positive Deviance (PD) in nursing is intentional and honorable behavior that departs or differs from an established norm and contains elements of innovation, creativity, and/or adaptability; it also involves risk.³ These nurses practice differently and more effectively to provide patient-centered care.⁴ Although professional standards guide care and lay the groundwork for best practices, they are …

Socioeconomic Indicators And Terrorist Incidents In Sub-Saharan Africa: An Empirical Panel Analysis, 1970 – 2020, Ifeoma Okoye, Suhaad Awudu, Kaeviya Butler

African Journal of Criminology and Justice Studies

Terrorism remains a major security and development challenge in Sub-Saharan Africa (SSA), yet the influence of socioeconomic conditions on terrorist activity remains unclear. This study examined the relationships between poverty, unemployment, GDP per capita, and terrorist incidents across 45 Sub-Saharan African countries using a quantitative explanatory design and secondary panel data from the Global Terrorism Database (GTD) and the World Bank's World Development Indicators (WDI). Terrorism trends were analyzed for 1970–2020, while inferential analyses focused on 2000–2020 because of greater socioeconomic data availability. Descriptive statistics, Pearson correlation, and negative binomial regression analyses were conducted using IBM SPSS Statistics. Pearson correlation …

Young-Onset Stroke In The Uae: A Single-Centre Retrospective Analysis Of Risk Factors And Outcomes, Sobia Siddiq, Saryia Adra, Kamel A. Samara, Batool Aldaher, Mohamad Emad Aldeen Mahfouz, Nour Sakan, Fathima Musfira, Roomiyah Riyaz Assadi, Ahlam Mohamed Almarzooqi, Hiba Jawdat Barqawi, Eman Abu-Gharbieh

Abington Jefferson Health Papers

BACKGROUND: Young-onset stroke represents a growing public health concern, yet data from the United Arab Emirates (UAE) remain limited. This study aimed to examine the risk factors and clinical outcomes associated with young-onset stroke in the UAE.

METHODS: A retrospective chart review was conducted on 419 patients aged below 50 years who were admitted at Al Qassimi Hospital, Sharjah, UAE, with a diagnosis of stroke between 2016 and 2022. Data on demographics, comorbidities, stroke subtype, management, and outcomes were collected and analyzed using Python-based statistical libraries.

RESULTS: The study population comprised predominantly of male individuals (78.28%), with most patients originating …