Medicine and Health Sciences Commons^™

Digital Pain Assessment: Patient And Family Perspectives, Rosemary Saunders, Kate Crookes, Kaoru Nosaka, Olivia Gallagher, Jeff Hughes, Caroline Bulsara, Max K. Bulsara, Seng Giap Marcus Ang, Beverley Ewens, Sue Haydon, Karla Seaman, Renée Graham, Debra Scaini, Karen Gullick, Michelle Gay, Christopher Etherton-Beer, Renée Graham

Research outputs 2022 to 2026

Background/Objectives: Pain is a common symptom for hospitalised older adults. Pain is not always adequately assessed, which can lead to inadequate pain management and adverse patient outcomes. Thus, new technology-driven pain assessment tools have been developed; however, little is known about patients’ and families’ experiences of nurses using them in acute care. This study aimed to explore the perspectives of older adult inpatients and their families’ regarding nurses’ use of the digital technology-driven pain assessment application PainChek^® Universal. Methods: A survey was undertaken as part of a stakeholder evaluation of a randomised control trial exploring the effectiveness of nurse-led …

Reimagining Peer-Led Support In Doctoral Nursing And Midwifery Education: A Collaborative Autoethnographic Case Study, Gideon U. Johnson, Sachini Thennakoon, Mayumi Kumarage, Emy Toutountzis, Lisa Whitehead

Research outputs 2022 to 2026

Aim: To explore how peer-led initiatives can enhance connection, belonging and sustainability within higher degree by research (HDR) nursing and midwifery programmes. Background: HDR study can be an isolating experience, often characterised by fragmented support and limited opportunities for structured peer learning. While institutions provide formal mechanisms for supervision and progress, less attention has been given to student-led approaches that cultivate inclusive scholarly communities and sustained peer engagement. Design: Collaborative autoethnographic case study. Methods: HDR student representatives and academic staff at Edith Cowan University, Australia (2022–2024), reflected collaboratively on the design, implementation and impact of peer-led initiatives, including monthly hybrid …

Bridging Ipv And Sud For Pregnant And Postpartum Women: A Case Report Of Interdisciplinary Programming In Mississippi, Catherine Poehling, Masoumeh Karimi, Chinedu Chukwu, Jerome R. Kolbo, Xiaoshan Gordy, Saijun Zhang, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsanee Davis, Sonja Fuqua, Mary M. Wesley, Lei Zhang

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

Addressing Health Inequities For People With Intellectual And Developmental Disabilities In The Hospital Through Partnerships In Nurse Training, Suzannah Iadarola, Amanda Laprime, Samantha Hochheimer, Tabby Anvari, Carrie Baker, Jacqueline Goodman

Developmental Disabilities Network Journal

People with intellectual/developmental disabilities (IDD) deserve the same access to quality healthcare yet are at increased risk of medical and/or psychiatric conditions as compared to the general population. Patients with IDD have less health satisfaction, shorter life expectancy, less access to preventative care, higher chronic health conditions, overuse of certain medications, and increased mortality. This population and their caregivers report high levels of dissatisfaction with emergency/inpatient care. Nurses also express frustration with lack of training, limited resources, and competing priorities.

We developed the Advancing Supportive Care through Education for Nurses on Disability (ASCEND) Program, to build the capacity of inpatient/Emergency …

Cv: Dena Hinkle (Nursing), Dena Hinkle

Nursing Department Faculty Curricula Vitae

No abstract provided.

Marital Satisfaction And Social Media Use: A Comparative Study Based On Addiction Levels, Fatma Ayhan, Elif Arık, Merve Gülsüm Saçan, Zehra Sevim, Esme Arguç

Makara Human Behavior Studies in Asia

In recent years, the widespread use of social media platforms has raised questions about their impact on marital relationships. This study examined the relationship between marital satisfaction, social media use, and certain sociodemographic characteristics. This descriptive and cross-sectional study comprised 461 individuals residing in Turkey who had been married for at least one year. Data were collected using the Bergen Social Media Addiction and Marital Satisfaction Scales. Statistical analyses included t-tests, analysis of variance, and multiple linear regression analysis. Social media addiction was high among 16.5% of the participants. Marital satisfaction was higher among males, those who married at age …

Staff Education On Attention-Deficit/Hyperactivity Disorder Identification And Referral Using The Vanderbilt Assessment Scale, Edith Nkeze

Walden Dissertations and Doctoral Studies

Staff Education on Attention-Deficit/Hyperactivity Disorder Identification and Referral Using the Vanderbilt Assessment Scale

Staff Education For Prevention And Management Of Obesity In Adolescents From Underserved Communities, Doris Mtarubukwa

Walden Dissertations and Doctoral Studies

This DNP project implemented a targeted staff education intervention designed to bridge the practice gap in obesity management among adolescents in underserved communities. A comprehensive chart review of 45 patients revealed that only 3% of encounters adequately addressed obesity using evidence-based practice (EBP) guidelines, establishing the urgent need for healthcare provider education and competency development. Adolescents in underserved communities face complex barriers to health and wellness, with obesity representing a critical public health concern. The literature demonstrated that childhood and adolescent obesity serves as a significant risk factor for multiple chronic conditions in adulthood, including Type 2 diabetes, hypertension, coronary …

Pressure Injury Prevention In Intensive Care Units, Michael Loya

Walden Dissertations and Doctoral Studies

This project addressed the critical practice problem of formation of Stage III/IV pressure injuries in adult patients admitted to the long-term acute care (LTAC) intensive care unit (ICU) department, which has been linked to increased lengths of stay, mortality rates, and treatment costs for the facility. Thus, development of a clinical practice guideline (CPG) focused on a nurse-driven protocol to identify patients in the ICU department at high risk of developing a Stage III/IV pressure injury and initiating prevention measures formed the primary purpose of the Doctor of Nursing Practice (DNP) project. The practice focused question addressed whether an evidence-based …

Staff Education On Phq-9 To Improve Depression Screening And Patient Outcomes, Ahmad Ghandour

Walden Dissertations and Doctoral Studies

Depression is a prevalent mental health condition that significantly affects patient quality of life and healthcare utilization. Clinical guidelines recommend routine depression screening in adults when appropriate systems for follow-up and treatment are in place. The Patient Health Questionnaire-9 (PHQ-9) is a validated instrument used to identify depressive symptoms and assess severity in outpatient settings. Despite national recommendations supporting routine depression screening using the PHQ-9, a significant practice gap remains in the consistent administration, accurate scoring, and proper documentation of the tool in outpatient. Research indicated that variability in screening practices is frequently associated with inadequate staff training and lack …

The Impact Of Simulation-Based Education On Novice Nurses’ Knowledge Of Pressure Injury Prevention, Michelle "Mikki" Cantu

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries remain a significant patient safety concern in acute care settings despite the availability of evidence-based prevention guidelines. Novice nurses, who often have limited clinical experience and exposure to wound care education, may be less prepared to consistently identify risk factors, accurately stage pressure injuries, and implement appropriate preventive strategies. Simulation-based education offers an experiential learning approach that supports the translation of evidence-based knowledge into clinical practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effectiveness of simulation-based education in improving novice nurses’ knowledge of pressure injury identification and prevention. The …

Quality Improvement Project: Enhancing Self-Efficacy Through Inacsl Standards Training, Amy Bortner

Doctor of Nursing Practice Projects

Simulation-based education (SBE) is a widely used instructional strategy in nursing curricula; however, formal training for faculty and staff who implement it may be inconsistent or limited. Current literature supports the need for structured, evidence-based training to ensure effective use of simulation-based education and promote best practices in teaching and learning. The Doctor of Nursing Practice (DNP) project aims to improve perceptions and self-efficacy regarding the use of the International Nursing Association of Clinical Simulation and Learning (INACSL) standards, which guide simulation education. Driven by Kurt Lewin’s change theory and Jeffries Simulation Theory, twelve volunteers completed the Faculty Attitude and …

Quality Improvement Project: Provider Knowledge Improvement For Care Of The Severely Hypertensive Obstetric Patient, Victoria Abramowitz

Doctor of Nursing Practice Projects

Gaps in confidence among emergency department (ED) and maternal child health services (MCHS) staff negatively impacts effectiveness and timeliness of response to high acuity obstetric emergencies, such as severe obstetric hypertension. The purpose of this quality improvement project was to evaluate the impact on provider self-efficacy with the implementation of evidence-based education and standardized procedures for severe obstetric hypertension management, aimed at evaluating the degree of success of increasing provider confidence. The project was guided by Lewin’s change theory and Donabedian’s structure-process-outcome theoretical framework. With a quasi-experimental design and the PDSA implementation framework, 20 staff from both the ED and …

Quality Improvement Project: Impact Of National Culturally And Linguistically Appropriate Services (Clas) Standards Education On Behavioral Health Providers’ Self-Efficacy, Zita Anigbou

Doctor of Nursing Practice Projects

Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners …

Implementation Of A Standardized Suicide Risk Screening Protocol Using The Columbia-Suicide Severity Rating Scale (C-Ssrs) In An Outpatient Mental Health Clinic, Kemisola Ebietomiye

Doctor of Nursing Practice Projects

The outpatient mental health clinics across the United States lack consistent suicide risk assessment methods. This project developed standardized procedures which used Columbia-Suicide Severity Rating Scale (C-SSRS) assessment together with provider education and electronic health record systems to evaluate how these elements impacted provider self-efficacy and their ability to record screening results. The project used a pre-post design to examine (n=24) psychiatric providers at an urban outpatient clinic through the combined methods of Lewin's Change Theory and the Plan-Do-Study-Act framework. The General Self-Efficacy Scale measured provider self-efficacy, and structured EHR audits tracked documentation rates pre- and post-implementation over six weeks. …

Quality Improvement Project: Empowering Nurses And Medical Assistants To Improve Medication Adherence: A Screening-Based Quality Improvement Initiative, Maria Garcia

Doctor of Nursing Practice Projects

Medication nonadherence is a persistent challenge in clinical settings that negatively influences patient outcomes and is often driven by cost, access, and patient-related barriers, as widely documented in the literature. Nurses and medical assistants play a critical role in identifying these barriers; however, inconsistent screening and limited staff confidence may hinder intervention. The purpose of this quality improvement project was to evaluate the impact of implementing the Brief Medication Questionnaire (BMQ) on staff confidence in addressing medication adherence and to assess clinic-wide utilization of the tool. The project was guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change …

Quality Improvement Project Standardizing Simulation In Nursing Education: A Faculty Training Initiative, Andrea Reyes

Doctor of Nursing Practice Projects

Simulation-based education is essential in nursing programs as clinical placement opportunities decline. However, inconsistent faculty preparation can compromise the quality of simulation delivery. The purpose of this quality improvement project was to implement and evaluate a standardized simulation faculty training initiative to determine its impact on nursing faculty's confidence in simulation facilitation. Guided by the Jeffries Simulation Framework and Lewin’s Change Theory, a quasi-experimental pre-post design was used to examine changes in faculty confidence following participation in a training program aligned with national standards and guidelines. Faculty confidence was measured using the Simulation Educator Needs Assessment Tool (SENAT) administered pre- …

Improving Diabetes Care: Staff Training On Updated Ada Guidelines, Jeffrey Wilson

Doctor of Nursing Practice Projects

The incidence of diabetes is rising, requiring clinical staff to stay current with the American Diabetes Association (ADA) Standards of Care. A lack of knowledge and outdated practices were revealed during the needs assessment at the project site. This quality improvement (QI) project sought to determine whether ADA‑centered educational training could impact staff members' knowledge of diabetes. Orem’s Self‑Care Deficit Nursing Theory and Lewin’s Change Theory served as the theoretical frameworks to promote provider competence and adherence to evidence‑based diabetes treatment. Quasi‑experimental pre–post design was used with a convenience sample of four clinical staff at a rural outpatient clinic. Study …

Quality Improvement Project: Protecting Young Kidneys: Optimizing Albuminuria Management In Youth With Diabetes, Mili Vakharia

Doctor of Nursing Practice Projects

Diabetic nephropathy is a major microvascular complication and the leading cause of chronic kidney disease (CKD) among individuals with diabetes. Children and adolescents with type 1 and type 2 diabetes face a higher risk of developing CKD earlier in life due to longer disease duration, poor glycemic control, and delayed CKD diagnosis. Guidelines emphasize timely detection and intervention to slow disease progression. Albuminuria is an early marker of glomerular injury and signals the need to initiate CKD treatment. Despite evidence supporting early detection and treatment, standardized management of albuminuria in pediatric diabetes care remains inconsistent. This Doctor of Nursing Practice …

Quality Improvement Project: Use Of The Behavioral Risk Assessment Tool To Enhance The Utilization Of The Behavioral Emergency Response Team, Joseph Sindhu

Doctor of Nursing Practice Projects

Workplace violence is a global challenge, and nurses often encounter patient aggression. The purpose of this quality improvement project was to enhance the use of a behavioral assessment tool derived from the Brøset Violence Checklist and the Behavioral Emergency Response Team (BERT) to de-escalate workplace violence. This project aimed to improve behavioral assessment documentation and BERT use in a critical care unit by 30% within 5 weeks. Guided by the Donabedian Model theoretical framework and Lewin's Change Theory, the project employed a quasi-experimental, pretest-posttest design in an advanced heart failure unit with full-time nurses as participants. The Plan-Do-Study-Act (PDSA) framework …

Standardizing Patient-Centered And Trauma-Informed Communication Practices Among Staff In A Behavioral Health Setting, Jayla Brown

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate the effect of an evidence-based educational intervention on staff attitudes toward trauma-informed and patient-centered communication in an outpatient behavioral health clinic. Guided by Lewin’s Change Theory and Jean Watson’s Theory of Human Caring, the project aimed to improve staff knowledge, attitudes, and confidence in applying trauma-informed communication strategies across all clinic roles. An eight-week educational intervention based on the SAMHSA Trauma-Informed Care Toolkit was implemented for clinical and administrative staff. A quantitative pretest–posttest quasi-experimental design was used, with outcomes measured using an adapted Attitudes Related to Trauma-Informed Care scale. All …

A Nurse-Led Clinical Practice Guideline To Improve Medication Adherence Among Psychiatric Home-Health Patients, Amber Murillo - Alonzo

Walden Dissertations and Doctoral Studies

Medication nonadherence among psychiatric patients receiving home-health services contributes to symptom relapse, preventable hospitalizations, and decreased quality of life. Inconsistent medication education and adherence monitoring within home-health settings may further exacerbate this problem. The purpose of this Doctor of Nursing Practice project was to develop and evaluate a nurse-led clinical practice guideline (CPG) designed to improve medication adherence among psychiatric home-health patients. The practice-focused question asked: What evidence, based on content expert review using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, supports the quality and usability of a CPG to improve medication adherence in a …

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Quality Improvement Project: Improving Pneumococcal Vaccination Rates Through Provider Education In Primary Care, Leikasha Allen

Doctor of Nursing Practice Projects

Pneumococcal disease remains a major cause of illness and mortality among adults aged 65 years and older, leading to severe pneumonia, bacteremia, and meningitis, particularly in vulnerable populations. Although effective vaccines and clear Centers for Disease Control (CDC) and Advisory Committee Immunization Practice (ACIP) guidelines, vaccination in this age group remains inadequate. This Doctor of Nursing Practice (DNP) quality improvement project aimed to determine the impact of pneumococcal vaccination compliance through evaluating provider knowledge, confidence, and adherence to evidence-based guidelines through targeted education. Guided by Rogers’ Diffusion of Innovation Theory and the Health Belief Model, a 20-minute evidence‑based educational session …

Implementation Of A Mentoring Toolkit: A Quality Improvement Project, Joshlyn Neu

Doctor of Nursing Practice Projects

Nursing faculty mentorship is an essential component of professional development, job satisfaction and faculty retention. However, many schools lack a structured approach to preparing their faculty members to act as mentors. This quality improvement project set out to determine whether the implementation of a formal mentoring toolkit would improve nursing faculty members perceived competency to act as mentors. Guided by Bandura’s Social Cognitive Theory (SCT), Lewin’s Change Theory, and the latest evidence-based research, this project sought to answer the following question: In full-time nursing faculty members teaching in a BSN program at a small, private college (P), how does the …

Staff Education To Improve Psychiatric Nurses’ Use Of Evidence-Based Strategies For Supporting Medication Adherence In Outpatient Settings, Lilian Ndifon

Walden Dissertations and Doctoral Studies

Psychiatric medication nonadherence remains a persistent barrier to effective outpatient mental health care and contributes to relapse, rehospitalization, and disrupted continuity of care. In outpatient psychiatric settings, nurses are often responsible for patient education and follow-up, yet many lack formal training in evidence-based strategies to support medication adherence. This staff education project was implemented at an outpatient psychiatric facility to address this practice gap. The practice-focused question asked whether a structured staff education intervention would improve outpatient psychiatric nurses’ knowledge of evidence-based medication adherence strategies. Twelve outpatient psychiatric nurses participated in a one-hour educational session focused on motivational interviewing, psychoeducation, …

Staff Education For Hypertension Diagnosis, Management, And Treatment, Philomena Ifeyinwa Chinemelu

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is a significant public health concern, and educating nursing staff is crucial to improving patient outcomes and supporting public health initiatives. This staff education project focused on improving the quality of hypertension management by empowering nurses to provide evidence-based, patient-centered care. The practice-focused question is as follows: Will HTN education improve staff knowledge of HTN diagnosis, treatment, and management? I employed a quantitative pre-test/post-test design to measure changes in staff (n = 10) knowledge before and after training. Descriptive statistics measure knowledge gain and the effectiveness of educational strategies. The pre-test percentage of correct answers improved from 79% …

Staff Education To Reduce Compassion Fatigue In Acute Care Staff Nurses, Kamala C. Mcgee

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF), burnout, and moral distress are common in high-acuity nursing environments, yet nurses are rarely taught how to recognize or manage these challenges. The guiding question for this staff education project was about whether education focused on CF and mindfulness-based coping strategies would improve nurses’ knowledge and attitudes in an acute care VA medical center. Posteducation results (n = 20) showed meaningful, statistically significant improvements. Familiarity with CF increased from baseline (M = 2.35; SD = 1.04) to post implementation (M = 3.75; SD = .91), t(19) = −5.085, p < .001. Confidence in recognizing CF in oneself improved from baseline (M = 2.6; SD = .875) to post implementation (M = 3.60; SD = .821), p = .004. Confidence in recognizing CF in colleagues increased from baseline (M = 2.40; SD = .821) to postimplementation (M = 3.15; SD = .671), p = .012. Agreement that seeking help is a sign of weakness decreased from baseline (M = 2.00; SD = .503) to postimplementation (M = 1.40; SD = .951), p = .024. Although perceptions of organizational support did not change, nurses reported greater use of mindfulness, peer support, and boundary setting, supporting nurse wellbeing and psychological safety. Several recommendations emerge from this project. CF education should be integrated into routine staff development, annual competencies, and onboarding for new nurses. By reducing stigma around seeking help and promoting peer awareness, this work supports fostering a workplace culture where all nurses feel safe, supported, and valued, a positive social change.

Optimizing Patient Adherence Through Improved Technology-Based Communication By Enhancing Staff Efficiency At An Opiate Treatment Program Clinic, Jennifer Parsons

Doctor of Nursing Practice Projects

High rates of missed appointments and unreliable follow-up remain a problem in outpatient opioid treatment clinics. This project improved the communication workflow at a methadone maintenance clinic by strengthening reminder systems and staff coordination. A needs assessment found several problems: appointment reminders were inconsistent, tracking was unreliable, and staff communication often relied on manual handoffs. The project was to test a technology-based workflow designed to improve staff communication and reduce missed appointments. The Technology Acceptance Model and Lewin’s Change Theory guided the change. The clinic implemented automated reminders, secure messaging, and clearer documentation to support daily communication. A pre-post evaluation …