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Staff Education To Improve Staff Knowledge Of Evidence-Based Strategies That Support Medication Adherence Among Patients Diagnosed With Depression In The Outpatient Clinic Setting, Comfort Aziwung Awungafac

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was an evidence-based practice staff education initiative designed to improve staff knowledge of evidence-based strategies that support medication adherence among patients diagnosed with depression in an outpatient clinic. Medication nonadherence is associated with poor treatment outcomes, symptom relapse, and reduced quality of life, highlighting the need for staff education on adherence-promoting interventions. The practice-focused question examined whether a structured educational intervention would improve staff knowledge of evidence-based medication adherence strategies over an 8-week period.

Burnout, Compassion Fatigue, Secondary Trauma, And Experiences With Death And Dying Among Organ And Tissue Recovery Professionals: A Hermeneutic Phenomenological Study, Shelby Andreasen

Walden Dissertations and Doctoral Studies

Professionals in organ and tissue recovery have complex job roles that affect the outcomes of patients who wait for a life-saving organ or a life-enhancing tissue graft. This profession had little research regarding burnout, compassion fatigue, and secondary trauma, as well as how consistent involvement with deceased patients affects these professionals and the outcomes of their cases. The purpose of this qualitative phenomenological study was to explore the lived experiences of 11 organ and tissue recovery professionals (OTRPs). Constructivist self-development theory was applied to understand OTRPs’ lived experiences of compassion fatigue, secondary trauma, and burnout, as well as the impact …

Weekly Team Validation Rounding Focused On Chlorhexidine Gluconate Bathing And Bath Completion And Documentation Compliance, La-Toya Therese Fong

Walden Dissertations and Doctoral Studies

This quality improvement project evaluated whether weekly team validation rounding improved chlorhexidine gluconate (CHG) bath completion and documentation compliance among eligible adult inpatients, with particular attention to differences in compliance outcomes between Pod 5C and Pod 4B. Background. Hospital-acquired infections continue to increase morbidity, mortality, length of stay, and healthcare costs. Although CHG bathing is an evidence-based strategy for reducing infection risk and the transmission of multidrug-resistant organisms, inconsistent documentation at the practicum site limited accurate monitoring of compliance across validation data, electronic medical record documentation, and DOMO reports. Method. Participants included eligible adult inpatients admitted within the previous 24 …

Fellowship Graduates’ Perceptions Of The Professional Competencies Developed In A Local Orthopedic Manual Physical Therapy Program In The Southern United States, Margaret Elaine Lonnemann

Walden Dissertations and Doctoral Studies

Orthopedic manual physical therapy (OMPT) fellowship programs focus on improving clinical skills and professional development in physical therapy. OMPT fellowship programs are 1–3-year postprofessional subspecialty training programs in manual physical therapy requiring prior orthopedic clinical experience. The problem that was addressed in this study is that professional competencies are not adequately assessed after program completion of an OMPT fellowship in the Southern United States. Grounded in Dreyfus’s skill acquisition model, the purpose of this basic qualitative study was to explore OMPT fellowship graduates’ perceptions of the professional competencies developed and recommendations for assessing these competencies in future graduates. Data were …

Usa V. William Manderville

2026 Decisions

USDC for the District of New Jersey

C-Reactive Protein–Albumin–Lymphocyte (Cally) Index As A Novel Inflammatory Marker For Sarcopenia: Evidence From A Cross-Sectional Study ​, Yasemi̇n Polat Özer, Merve Güner, Serdar Ceylan, Engi̇n Çeşmeci̇, Cafer Balci, Burcu Balam Doğu, Meltem Gülhan Hali̇l, Mustafa Cankurtaran, Mert Eşme

Turkish Journal of Medical Sciences

Background/aim: Sarcopenia is a geriatric syndrome characterized by progressive impairments in skeletal muscle mass and performance, with chronic low-grade systemic inflammation playing a pivotal role in its development. The C-reactive protein–albumin–lymphocyte (CALLY) index reflects inflammatory burden alongside immune and nutritional status; however, its association with sarcopenia in older populations has yet to be sufficiently elucidated. The present study investigates the relationship between CALLY index values and probable sarcopenia (PS) in a large cohort of geriatric outpatients.

Materials and methods: Included in this retrospective cross-sectional study were 2042 geriatric outpatients aged ≥65 years who were assessed between May 2022 and March …

Association Of Occupational Lead Exposure With Erythrocytic Parameters And Nitric Oxide–Related Metabolites: A Case-Control Study ​​, Meli̇h Gaffar Gözükara, Servet Bi̇rgi̇n İri̇taş, Deni̇z Özkan Vardar, Lütfi̇ye Tutkun, Özlem İri̇taş, Serdar Deni̇z, Vugar Ali̇ Türksoy, Engi̇n Tutkun

Turkish Journal of Medical Sciences

Background/aim: Occupational lead (Pb) exposure remains a significant public health concern due to its persistent presence in industrial environments and its cumulative toxic effects. Although the hematological and neurological consequences of Pb exposure are well documented, early vascular effects and the mechanisms associated with potential endothelial impairment remain unclear. This study aimed to investigate the associations between Pb exposure, erythrocytic parameters, and nitric oxide (NO)–related metabolites (asymmetric dimethylarginine [ADMA], symmetric dimethylarginine [SDMA], arginine, homoarginine, and citrulline) to identify early biomarkers that may suggest impairment in NO-related pathways.

Materials and methods: This case-control study included a strictly selected cohort of 125 …

Vitamin D Deficiency, Depression Severity, And Suicide Risk: Evidence From Patients With Major Depressive Disorder ​, Eli̇f Küçük, Feri̇de Uysal, Seda Şenkardeş Kandemi̇r, Özgür Özkalayci, Canay Pamukçu, Ni̇hal Taşteki̇n, Meri̇h Altintaş

Turkish Journal of Medical Sciences

Background/aim: Major depressive disorder (MDD) is a common psychiatric condition characterized by depressive symptoms and suicide-related clinical features. Vitamin D status has been investigated as a potential clinical correlate of depression and suicidal ideation, but the direction and specificity of these associations remain uncertain. This cross-sectional study aimed to examine the associations among serum 25-hydroxyvitamin D [25(OH)D] levels, depressive symptom severity, suicidal ideation, and suicide-related cognitive–affective dimensions in adults diagnosed with MDD.

Materials and methods: This cross-sectional study included 97 adults aged 18–65 years who were diagnosed with MDD according to DSM-5 criteria. Depressive symptom severity and suicide-related outcomes were …

Demographic And Clinical Characteristics Of Frequent Users Of Emergency Medical Services In Türkiye ​, Burak Bekgöz, İshak Şan

Turkish Journal of Medical Sciences

Background/aim: Overuse of emergency medical services (EMS), particularly unnecessary ambulance requests, places considerable strain on limited healthcare resources and can delay responses to urgent cases. The present study analyzes the demographic characteristics, diagnoses, urgency, and hospital transfer status of frequent users of EMS in Türkiye.

Materials and methods: Included in the study were 41,113 patients who requested EMS four or more times within a year (defined as frequent users for the purpose of the study), excluding interhospital transfers. Data were accessed from the Emergency Medical Services Automation System (ASOS) database, which contains details of patient demographics, diagnoses, triage codes, reasons …

Measurement Of Resection Volume Using Computed Tomography 3d Modeling In Lung Cancer Patients And Survival Analysis ​, Aykut Kankoç, Muhammet Tarik Aslan, Muhammet Sayan, Ali̇ Çeli̇k, Cüneyt İsmai̇l Kurul, Abdullah İrfan Taştepe

Turkish Journal of Medical Sciences

Background/aim: The prognostic significance of the volumetric extent of lung resection in nonsmall cell lung cancer remains uncertain. Three-dimensional computed tomography allows quantitative assessment of resected lung parenchyma, but the relationship between resection volume ratios and oncologic outcomes has not been clearly established. The aim in this study was to evaluate the prognostic value of three-dimensional computed tomography-derived resection volume ratios for disease-free survival after surgery for nonsmall cell lung cancer.

Materials and methods: This single-center retrospective study included 141 patients who underwent anatomical resection with systematic mediastinal lymph node dissection between 2010 and 2021. Resection volume, ipsilateral lung volume, …

Closing The Loop: Strengthening Cauti Prevention With Urinary Catheter Management, Erika N. Braun

Master's Projects and Capstones

Objective: Catheter-associated urinary tract infections (CAUTIs) are among the most common preventable healthcare-associated infections and are associated with significant patient harm and increased healthcare costs. Baseline assessment across five adult cardiovascular and critical care units within a community-based acute care hospital identified four CAUTI events during the first half of 2026 and revealed important nursing knowledge deficits related to bladder scanning protocols and urinary catheter management practices. Aim: This Quality Improvement (QI) Project aimed to improve nursing knowledge of evidence-based bladder scanning protocols and urinary catheter management practices through targeted educational interventions implemented over a 10-week period, with …

Teachers’ Communicative Experiences Of Media And Information Literacy (Mil) In Peri-Urban Schools In The Southern Philippines: A Hermeneutic Phenomenological Analysis, Author Information Removed

JMLE Submissions Open for Review

Media and Information Literacy (MIL) has become increasingly important as education responds to an increasingly complex information environment, yet less is known about how teachers experience and make sense of teaching it, particularly in resource-constrained contexts. Guided by Gadamerian hermeneutic phenomenology, this study explored the lived communicative experiences of seven Senior High School teachers from five peri-urban public schools in the Southern Philippines. In-depth interviews revealed three interconnected, culturally situated meanings: pagsugakod (carrying on amid uncertainty), pagtagad (attentive responsibility), and pagkabalaka (ongoing concern). Together, these meanings show how teachers navigate limited preparation, respond to students’ lived circumstances, and teach within …

Assessment Of Pareto Optimal Projection Search Algorithm For Next Generation Radiotherapy Planning In Prostate Cancer Treatment, Khanh Pham

Masters Projects

Purpose: Automated treatment planning systems (ATPS) are critical for improving plan consistency and efficiency. This study evaluated the implementation and performance of the Pareto optimal projection search algorithm (POPSA), a proprietary rule-based algorithm (RBA) in prostate site. The RBA's performance was benchmarked against established knowledge-based planning (KBP) and deep learning (DL) dose prediction tools.

Methods:  A retrospective comparative study used a cohort of N=10 previously treated patients, consisting of 10 prostate with lymph nodes cases. Three plans were generated per patient: manual reference (RA) plan, KBP plan, and RBA script-only plan. Performance was quantified by target volume coverage, organ at …

A Dosimetric Comparison Of 6-Mv Flattening Filter And Flattening Filter-Free Photon Beams For Stereotactic Body Radiation Therapy Of Adrenal Tumors, Sarah Mcintosh

Masters Projects

Purpose: This study aimed to compare dosimetric characteristics and treatment delivery efficiency between 6-MV Flattening Filter (FF) and Flattening Filter-Free (FFF) photon beams for adrenal Stereotactic Body Radiation Therapy (SBRT). While FFF beams have demonstrated dosimetric and efficiency advantages at other SBRT sites, there is limited data about their use in adrenal SBRT.

Methods and Materials: A retrospective dosimetric comparison was performed using 10 patients previously treated with adrenal SBRT. For each patient, two Volumetric Modulated Arc Therapy (VMAT) plans were generated in Eclipse: one using 6-MV FF beams and one using 6-MV FFF beams, resulting in 20 total treatment …

Examining The Association Between Socioeconomic Factors And Cervical Cancer Among Minority Women In The United States, Darla Fils

Walden Dissertations and Doctoral Studies

Cervical cancer remains a significant public health concern, with African American and Hispanic women experiencing disproportionately higher incidence and mortality rates in the United States. Socioeconomic factors, including income, education, employment status, and place of residence, may contribute to these disparities by affecting access to preventive services, timely diagnosis, and follow-up care. This quantitative cross-sectional study examined associations between these factors and cervical cancer incidence among African American and Hispanic women while controlling for age and health insurance status. Guided by the socio-ecological model, the study used 2022 Behavioral Risk Factor Surveillance System data from N = 33,886 African American …

Staff Education To Improve Diabetic Care In A Primary Care Setting, Sally Uyen Nguyen

Walden Dissertations and Doctoral Studies

Inadequate patient education, inconsistent screening, missed referrals, and follow up with diabetes patients are challenges primary care managers and staff must overcome. Patients may experience negative effects that lead to poor health outcomes, delayed diagnosis, and undertreatment when provider and staff members are not educated about diabetes. The practice-focused question guiding the Doctor of Nursing Practice (DNP) staff education project involved exploring whether a staff education intervention on standardized diabetes care and screening protocols could improve physicians, managers, and medical assistants’ (MAs) knowledge of diabetes care in primary care clinics. The purpose of this project was to enhance staff knowledge …

A Phq-9 Depression Screening Staff Education Program For Outpatient Nurses, Kaliym Hassaan Howell

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was an educative project to improve staff knowledge of the Patient Health Questionnaire-9 (PHQ-9) in an outpatient behavioral health unit. The PHQ-9 is a nine-item depression screening scale to evaluate depressive symptoms presence and severity (Ford et al., 2020; Negeri et al., 2021; Stanyte et al., 2023). One identified practice issue was a knowledge gap in administration, scoring, and interpretation of PHQ-9 among nurses, which was noted by inconsistencies in the interpretation and use of the tool. Since nurses are essential in PHQ-9 administration and interpretation, systematic education was needed to enhance competency. …

Staff Education To Improve Early Identification Of Behavioral Escalation And Timely Clinical Intervention In An Adult Group Home Setting, Gayduo Barr

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project addressed a gap in staff knowledge regarding the early identification of behavioral escalation and timely intervention in an adult group home setting. The practice-focused question was: Does staff education about early identification of behavioral escalation and timely clinical intervention improve the knowledge of staff working in an adult group home setting? The purpose was to improve staff knowledge of behavioral escalation, triggers, trauma-informed care, and intervention strategies. I delivered a structured educational intervention to 14 house managers. Educational content included behavioral escalation stages, triggers, de-escalation techniques, trauma-informed care, documentation, and …

Staff Education On An Electronic Health Record-Based Tracking And Reminder System For Long-Acting Injectable Antipsychotics, Osereme Nora Agboifo

Walden Dissertations and Doctoral Studies

Missed or delayed administration of long-acting injectable (LAI) antipsychotic medications remains a practice concern in outpatient mental health care because treatment gaps can interrupt continuity, increase relapse risk, and contribute to avoidable hospitalization. The practice problem addressed in this staff education project was inconsistent use of a standardized electronic health record (EHR)-based LAI tracking and reminder workflow. The project purpose was to improve staff knowledge, documentation consistency, reminder use, and follow-up practices for adults receiving LAI antipsychotic medications. The practice-focused question asked whether staff education on an EHR-based LAI tracking and reminder system would improve adherence monitoring and follow-up processes …

Staff Education On Fall Reduction For Residents Of Long-Term Care Facility, Lauretta Ifeoma Iwuala-Mcwilliams

Walden Dissertations and Doctoral Studies

Falls pose a major safety risk for elderly individuals living in long-term care facilities, leading to injuries, hospitalizations, loss of autonomy, increased healthcare expenses, and higher morbidity and mortality rates. In the facility involved in this project, the incidence of falls was above anticipated benchmarks. Factors such as high staff turnover and reliance on agency staff resulted in inconsistent knowledge among personnel regarding fall prevention measures. Purpose: This Doctor of Nursing Practice quality improvement initiative aimed to implement and assess an evidence-based educational program designed to enhance staff understanding and skills related to fall-risk assessment, the identification of both intrinsic …

Improving Provider Awareness Of Stimulant-Associated Risks In Patients With Attention-Deficit/Hyperactivity Disorder And Comorbid Anorexia Nervosa Through Provider Education, Quenia Alfrenard

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a quality improvement initiative designed to improve provider knowledge regarding the identification and management of young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and comorbid anorexia nervosa in an outpatient behavioral health clinic. Evidence has demonstrated a significant association between ADHD and eating disorders; however, this comorbidity is frequently underrecognized in clinical practice, contributing to challenges in treatment selection and patient safety. Stimulant medications, the first-line pharmacologic treatment for ADHD, may suppress appetite and promote weight loss, potentially worsening anorexia nervosa and delaying nutritional recovery (Shear et al., 2021). Consequently, providers must understand …

Non-Veteran Civilian Manager Perceptions About Supporting Employee Military In Civilian Workplace Transitions, Sandra Gail Piggee

Walden Dissertations and Doctoral Studies

One of the largest populations seeking employment in private sector industries is military veterans. The active-duty military careers end for over 200,000 individuals per year, and over two-thirds of veterans resign from private sector industry positions within 2 years of post-service transition due to difficulties with their transition. This can lead to a lack of career advancement, professional development, and employee benefits. The purpose of this generic qualitative study was to explore perceptions of non-veteran civilian managers in private sector industries about how to support employees who are veterans in making a successful transition from the military into civilian employment. …

Postsecondary Experiences And Impact On Career Choices And Employment Status For Cisgender Women With Autism, Maureen Bell

Walden Dissertations and Doctoral Studies

Cisgender women with autism remain underrepresented in research on postsecondary education and career development despite experiencing distinct barriers within these systems. This qualitative study examined how cisgender women with autism perceived the impact of their postsecondary education experiences on career choices and employment navigation. Guided by the social model of disability and intersectionality theory, nine postsecondary participants formally diagnosed with autism and who self-identified as cisgender completed semistructured interviews exploring their educational and employment experiences. Thematic analysis identified seven interconnected themes. Findings indicated that academic success often masked significant internal distress, suggesting that performance did not reflect accessible environments. Participants …

Kindergarten Classroom Educators’ Perceptions Of Social Emotional Learning Implementation, Thomasina A. Millner

Walden Dissertations and Doctoral Studies

The problem addressed in this study was that research on social emotional learning (SEL) has largely focused on student outcomes, program effectiveness, and implementation practices, but limited research has examined kindergarten classroom educators’ perceptions of implementing SEL. Grounded in the Collaborative for Academic, Social, and Emotional Learning framework, the purpose of this study was to explore kindergarten classroom educators’ perceptions of SEL implementation. For this basic qualitative design, semistructured interviews with nine kindergarten educators who had at least 1 year experience implementing SEL were conducted. Through thematic data analysis the following five themes emerged: Educators noted (1) that SEL is …

Effective Strategies For Implementing Artificial Intelligence To Improve Businesses’ Value Chains, Jehan Forsythe

Walden Dissertations and Doctoral Studies

Organizational leaders are increasingly adopting artificial intelligence (AI) to improve business operations; however, leaders of small and medium enterprises (SMEs) continue to face challenges associated with AI adoption. Understanding strategies for effective AI integration may facilitate AI adoption in SMEs, helping to enhance organizational value and improve competitive positioning. Grounded in Porter’s value chain framework, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies that U.S. SME leaders use to integrate AI into their value chain to increase organizational value and gain a competitive advantage. The participants were six U.S. SME leaders who led …

Prekindergarten Teachers' Perspectives On Coaching Following Professional Development On Early Childhood Programs, Donna Renee Morton

Walden Dissertations and Doctoral Studies

Coaching is recommended for prekindergarten (PK) teachers following professional development (PD) to increase implementation of instruction practices with fidelity in early childhood (EC) programs. The problem addressed in this study was PK teachers were challenged to engage in coaching experiences after PD to implement instructional practices with fidelity in a large EC program located in the Mideastern United States. Framed by Knowles’s adult learning theory, the purpose of this basic qualitative study was to explore PK teachers’ perspectives on coaching experiences after receiving PD to implement instructional practices with fidelity. Semistructured interview data were collected from eight PK teachers who …

Staff Education To Improve Staff Knowledge On Fall Prevention, Nginjoh Presilia Njofang

Walden Dissertations and Doctoral Studies

Patient safety risks associated with falls are a major issue in adult inpatient medical-surgical environments because nursing inconsistencies with regard to fall risk assessments, individualized fall prevention interventions, and documentation could impede adherence to best practices. To overcome this knowledge gap among RNs in the selected environment, a DNP education project aimed at standardized fall-prevention staff education was initiated. The question for the practice was whether standardized staff education would increase knowledge among nurses regarding fall-risk assessments, preventive measures, and documentation requirements, based on pretest and posttest results. In the course of a one-hour educational session conducted face-to-face, twenty RNs …

The Lived Experiences Of Intimacy And Isolation In Single Mothers During Covid-19: An Eriksonian Perspective, Chante Renee Reeves

Walden Dissertations and Doctoral Studies

Single mothers were largely absent from the COVID-19 literature, despite being head of household in approximately 80% of single-parent homes. The purpose of this phenomenological qualitative research study was to gain insight into the lived experiences of single mothers during the COVID-19 pandemic. This study addressed how this group connected with family, friends, and others in meaningful ways despite government-imposed lockdowns and restrictions. This phenomenon was explored through Erik Erikson’s psychosocial development theory, with a focus on the intimacy versus isolation stage. An Eriksonian perspective on relationship building and maintenance in adulthood can help better understand and address the social …

Completion Outcomes And Predictive Characteristics In Mandated Inpatient Substance Use Treatment, Tina Marie Moyer

Walden Dissertations and Doctoral Studies

Treatment retention, specifically as it pertains to offenders who are mandated to receive substance use treatment rather than serve standard incarceration sentences, is receiving more scholarly attention. Although prior research indicates an association between substance use treatment and reduced criminal behavior, many studies have methodological limitations. The purpose of this quantitative non-experimental, comparative study was to compare treatment completion outcomes for mandated and non-mandated offenders and to examine individual predictors of treatment completion, thereby addressing gaps in the current research. Secondary data from adult offenders receiving treatment at an inpatient substance use rehabilitation facility were analyzed. The risk-needs-responsivity model was …

Licensed Counselors’ Professional Well-Being During The Covid-19 Pandemic, Jacqueline Flaherty

Walden Dissertations and Doctoral Studies

According to the American Counseling Association (ACA, 2014) Code of Ethics, professional counselors are responsible to monitor their own impairment. Specific interventions to prevent impairment and foster counselor professional well-being (PWB) and resiliency are imperative in a profession in which it is ethically required to continuously provide competent counseling. The purpose of this study was to explore the narratives of licensed counselors’ PWB during the onset of and successively during the coronavirus disease 2019 (COVID-19) pandemic. The theoretical orientation for this study was Dewey’s theory of experience. Nine counselor participants who were licensed by May 2018 shared detailed accounts of …