Medicine and Health Sciences Commons^™

Strengthening Communication Between Staff And Health Providers In A Mental Health Setting, Michael Tricoli

Doctoral Dissertations and Projects

Communication between nursing staff and providers is essential for supporting optimum patient outcomes. Each component of the communication process needs to be clearly defined to create an environment of safety for both patients and caregivers. The SBAR (situation, background, assessment, recommendation) is a nurse-driven protocol that is widely used as a communication and documentation template in health care organizations. This format is currently not being used effectively on the mental health units where the evidence-based project was implemented. Recognizing and reiterating the value of SBAR as a communication tool is necessary when communication deficits are noted. The purpose and scope …

Implementation Of An Educational Intervention To Improve Antibiotic Stewardship In An Urgent Care Setting, Evelyn Jane Clinton

Doctoral Dissertations and Projects

Antimicrobial resistance is a leading threat to global health. Resistance to antibiotics in the United States continues to increase contributing to rising numbers of resistant infections and subsequent deaths. This highlights the critical need for increased focus on antibiotic stewardship efforts. Urinary tract infections are one of the leading indications for antibiotic prescription in the outpatient setting and research suggests that there is an opportunity for improvement in antibiotic stewardship efforts in this area. The PICOT question for this project is as follows: In an urgent care setting, does provider education on the current evidence for urinary tract infection diagnosis …

Improving New Graduate Nurse Clinical Judgment By Training Preceptors On The Use Of The Tanner Model, Denise E. Carr

Doctoral Dissertations and Projects

New graduate nurses (NGNs) often enter the workforce with deficits in clinical judgment, which has been further exacerbated by pandemic-related limitations in clinical education. This project aimed to improve NGN clinical judgment by training preceptors to use the Tanner Clinical Judgment Model (TCJM) and Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental evaluation design was used to compare outcomes between two groups of preceptor–preceptee pairs. Half of the preceptor participants received training on the TCJM and LCJR, while the other half did not. Clinical judgment development was measured using the LCJR pre- and post-orientation. Additional preceptor feedback regarding the implementation and …

Humanizing The Icu: Implementation Of Personalized Communication Boards In The Sicu Drives Enhanced Patient And Family Experience, Stephen D. Hoefler

Master's Theses

Objective: Research has established the importance of personalized communication in critical care settings, where standardized tools like whiteboards can improve patient and family engagement.

Aim: This project aims to develop a personalized communication board in the surgical intensive care unit (SICU) at a Bay Area academic quaternary care facility that, once implemented, will achieve at least 75% utilization in patient rooms by May 2025, enhancing communication and patient experiences.

Methods: Surveys were conducted with patients, families, and staff to gather stakeholder input and guide the design of a new standardized whiteboard model with personalized elements. Results: Based on stakeholder feedback, …

Psychometric Evaluation Of The Thai Version Of Emotional Labor Scale (T-Els) In Thai Nurses, Vachira Posai, Wisarut Srisintorn, Paramee Thongsuksai, Chanokporn Jitpanya

Journal of Health Research

Background: Nurses often face emotional strain due to emotional labor (EL), which involves concealing or modifying genuine feelings to meet their job requirements. This response can lead to physical, psychological, and behavioral issues. The Emotional Labor Scale (ELS), originally in English, has not been translated into Thai, leaving its psychometric properties unexamined in the Thai context. This study aimed to translate the ELS into Thai and evaluate its psychometric properties among Thai nurses.

Methods: A cross-sectional study design was used. The 14-item scale, which includes surface acting, deep acting, and expression of naturally felt emotions dimensions, was translated using forward …

A Clinical Practice Guideline For Enhanced Rehabilitation Assessment In Poststroke Patients, Chanda Honeywood

Walden Dissertations and Doctoral Studies

This doctoral project aimed to develop clinical practice guidelines (CPG) to strengthen the assessment of poststroke patients for rehabilitation. The project sought to adopt an evidence-based approach to develop standardized recommendations that can help in the timely and appropriate rehabilitation of stroke survivors, thereby reducing the risk of long-term disability and readmissions. Stroke is a significant cause of disability and poor functional recovery, increased healthcare costs, and lower quality of life for patients occur because of poor rehabilitation assessment. While rehabilitation protocols already exist, discrepancies in patient evaluations result in intervention delays and ineffective uptake of rehabilitation programs, limiting the …

Using The Token Economy To Improve Show Rates In An Outpatient/Community Mental Health Clinic, Gertrude Nabila Ndansi

Walden Dissertations and Doctoral Studies

The type of project was a quality improvement intervention. The identified practice problem was limited appointment shows among patients with appointments. Outpatient clinics often struggle with patients not showing up for appointments. Addressing this gap was critical for improving patient outcomes and resource efficiency. The practice problem must be addressed within the context of nursing practice by enhancing access to consistent mental health care and giving patients more timely support, leading to better outcomes and overall wellbeing.

Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha

Walden Dissertations and Doctoral Studies

This project was developed as a staff education program using the analyze, design, develop, implement, and evaluate (ADDIE) model with a focus on discharge planning in a medical clinic in northern Maryland. There is a gap in discharge planning for older adults due to shortage of providers and inadequate education related to care transitions among the elderly. The care transition process can be improved through education. The practice focused question was: “Does an educational project for nurses on care transitions for the elderly increase knowledge as compared pre-to post education?” The Johns Hopkins evidence-based practice model (Appendix A) was the …

Preoperative Clinical Practice Guidelines For Patients Undergoing Coronary Artery Bypass Graft Surgery, Marjorie Badong Yumul

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Marjorie B. Yumul has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Patricia Schweickert, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Executive Summary: Clinical Practice Guideline Preoperative Clinical Practice Guidelines for Patients Undergoing Coronary Artery Bypass Graft Surgery by Marjorie B. Yumul MS, University of the Philippines Manila, 2003 BS, La Concordia, …

Nurses’ Role In Reducing Mental Health Stigma In Healthcare, Olufunmilayo Elizabeth Adeloye

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a targeted educational intervention to reduce mental health stigma among healthcare providers. Mental health stigma, often resulting in misdiagnosis, delayed treatment, and decreased patient engagement, represents a significant barrier to effective nursing practice. The project’s practice-focused question examined whether an educational program could improve provider knowledge and attitudes toward mental illness. Using the ADDIE model (analysis, design, development, implementation, and evaluation), a needs assessment at a family practice and behavioral healthcare clinic identified gaps such as judgmental perceptions, avoidance behaviors, and lack of empathy among providers. An extensive literature review supported the …

Registered Nurses’ Perceptions Of Patient Safety In Critical Care Units, Martha Benghie Hyacinthe

Walden Dissertations and Doctoral Studies

Patient safety is a cornerstone of effective healthcare delivery, particularly in critical care units (CCUs) where patients are at heightened risk of complications due to their complex medical conditions. The purpose of this study, guided by Watson’s theory of human caring, was to explore RNs’ perceptions of patient safety in CCUs. Data on eight RNs working in CCUs were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Data were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Using Saldana’s method of thematic analysis, three overarching themes emerged: patient safety, resource allocation, and …

Maternal Access For Depression In Rural Environments, Simone Parlier

Dissertations

Significance –As many as 25% of birthing persons experience postpartum depression (PPD) within the first year after childbirth making this one of the most common postpartum disorders. PPD is prevalent, incapacitating, and treatable. The first step is identifying those at risk. Rural birthing persons are understudied, and may have unique predisposing characteristics as well as geographic challenges for optimal detection and treatment of PPD. Purpose -The long-term goal is to improve the health of rural families. Using The Theory of Unpleasant Symptoms, the purpose of this descriptive, cross-sectional research was to describe the prevalence of PPD in rural birthing persons …

Assessment Of Relationships Between Quality And Staffing In The Ambulatory Care Environment, Rachel E. Start

Dissertations

ABSTRACT Background The United States healthcare system underperforms compared to other industrialized countries where cost and quality are concerned. Nursing is accountable, as a profession recognized by society, to ensure health and livelihood in the patients and populations served. Advancing the role of the ambulatory care nurse and providing valid strategies to measure the contribution of the nursing profession in this setting is a tactic that many organizations are pursuing to achieve this paradigm shift. The assessment of relationships between measures of structure, process, and outcome within the ambulatory care setting across a variety of organizations may have the potential …

Comparison Of Two Injection Techniques On Pain Perception Among Adult Patients Receiving Intramuscular Injection: A Randomized Controlled Trial, Dr.Sindhu L, Dr. Bindu R. Nayar, Dr. Rajamohanan Pillai K

Manipal Journal of Nursing and Health Sciences

Introduction: The administration of intramuscular injection is a common procedure performed by nurses that causes pain to the patient. The way nurses administer injections is one of the factors associated with increased client discomfort. Aspiration has been ingrained in the intramuscular injection procedure, and even though many policies no longer endorse it, it is often frequently taught and used. Injections without aspiration are considered more comfortable for patients. Aspiration in the injection is a controversy concerning its perceived benefits and indications due to a paucity of available data, there is no evidence that this procedure is essential or truly …

Staff Education On Uti Screening, Antimicrobial And Antibiotic Resistance, And Poor Regimen Adherence, Shereen Robinson

Walden Dissertations and Doctoral Studies

This staff education project focused on enhancing nurses’ knowledge of urinary tract infections (UTIs) and antibiotic and antimicrobial resistance intended to promote screening for UTIs. The practice problem addressed was lack nurses’ knowledge of UTI screening and antibiotic resistance. Inadequate screening contributed to increased UTI rates, re-occurrences, and complications such as delirium. It was essential to address the issue because nurses are at the frontline regarding educating, screening, and providing care to patients with UTIs. Knowledgeable nurses can implement standard practices to ensure adequate screening for UTIs. Effective screening would enhance early treatment and minimize misuse and unnecessary antibiotic prescriptions. …

Bereavement Needs Of Parent-Child Dyads Following Sibling Death, Shannon V. D'Alton

MUSC Theses and Dissertations

In the United States, nearly 62,000 children and adolescents experience the death of a sibling each year and sibling bereavement is one of the most distressing life events during childhood; however, it has received less attention in research compared to other forms of childhood loss. Bereaved siblings and parents are at increased risk for negative physical and psychological outcomes, yet little is known about their support and resource needs during the early years following the death. A limitation in understanding sibling bereavement is the methodological and ethical challenges of researching this vulnerable population. Consequently, the bereavement needs of surviving siblings …

Policy Paper Assessing The Risk Of Obstructive Sleep Apnea In The College Football Player, Joseph C. Archer

Doctor of Nursing Practice Projects

Sleep is a vital yet often overlooked component of athletic performance, particularly in collision sports such as football. Despite growing evidence connecting obstructive sleep apnea (OSA) with cognitive impairment, cardiovascular risk, and injury, standardized screening is rarely implemented in collegiate athletics. This project aimed to assess the risk of obstructive sleep apnea (OSA) in college football players aged 18–25 using the STOP-BANG screening tool and to evaluate the impact of an educational intervention on the knowledge of athletic trainers. The purpose was to identify at-risk athletes early, promote timely intervention, and improve athletic trainers' understanding of OSA. The project addressed …

Clinical Practice Guideline For Systemic Lupus Erythromatosus And Lupus Nephritis, Seleaina A. Thomas

Walden Dissertations and Doctoral Studies

Summary This project addressed the critical practice problem of delayed and inaccurate diagnosis of systemic lupus erythematosus (SLE), which has been linked to increased morbidity and mortality, particularly among marginalized populations. These diagnostic challenges have been recognized globally, with international research highlighting inconsistencies in care and the absence of standardized guidelines. Implementing inclusive and equitable clinical practice guidelines (CPGs) that consider social determinants of health, political determinants of health and actively involve diverse populations in research can play a crucial role in reducing racial disparities and improve outcomes for all lupus patients. Thus, the development of a CPG focused on …

Staff Education To Registered Nurses On An Inpatient Pediatric Unit Regarding Pediatric Burn Principles, Qwinnetta Janae Stokes

Walden Dissertations and Doctoral Studies

The purpose of this staff education project was to improve nurses’ knowledge on burn care using an educational intervention. The project site became the children's hospital designated burn unit. Children with burns were a new patient population that the project unit had never cared for, and there was no formal training or competencies for nurses caring for these patients. Nurses requested formal education before being expected to care for these patients. This project utilized a single group, pre-post design comparing knowledge of bedside surgical nurses about pediatric burn care management principles before and after the educational intervention. The intervention was …

Staff Education On Substance Use Screening In An Outpatient Mental Health Clinic, Kelvin Okwudiogor

Walden Dissertations and Doctoral Studies

This DNP project aimed to enhance the quality of care by improving healthcare providers’ knowledge and fostering confidence in the utilization of screening, brief intervention, and referral to treatment (SBIRT). At the practice site, patients were not screened for substance use due to the lack of provider knowledge on evidence-based screening tools. The practice-focused question for this project was, Among healthcare providers in outpatient mental health clinics, does education on the use of the SBIRT screening tool increase their knowledge and skill after educational intervention? The project used a sample of 12 healthcare professionals, including four mental health practitioners and …

Standardizing Discharge Planning To Reduce Readmission Rates In Outpatient Mental Health Clinics, Navasha Martin

Walden Dissertations and Doctoral Studies

Psychiatric readmission rates remain a major concern in outpatient mental health clinics, often resulting from inconsistent discharge practices and limited patient education. This Doctor of Nursing Practice (DNP) project aimed to develop and evaluate a clinical practice guideline (CPG) to standardize discharge planning and reduce psychiatric readmission rates. Guided by the question: Does evidence support the quality of an evidence-based standardized discharge planning protocol to reduce readmissions?, this project integrated findings from a structured literature review and expert panel evaluation. The CPG was developed using evidence-based strategies and evaluated using the AGREE II instrument, a validated tool for assessing the …

Dementia Care: The Role Of Experiential Learning In Nursing Education, Jeannie Simpson

Wisdom & Compassion: The LUSON Journal

The escalating global prevalence of dementia necessitates enhanced educational strategies to prepare nursing students to care effectively for individuals living with dementia. Traditional methods in nursing education predominantly focus on pharmacological treatments and basic caregiving strategies, often neglecting innovative approaches like the Music & Memory® program, Virtual Dementia Tour®, and Montessori dementia. By including these innovative approaches, future nurses will be better equipped to develop and implement person-centered care for individuals living with dementia to improve their quality of life. The integration of these approaches will also meet the growing demands of dementia care, aligning with global health mandates.

Hope And Blessings: A Homeless Student’S Story, Kennedy Pazos

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Exploring Prelicensure Bsn Students’ Knowledge Of Mindfulness Meditation Using A Smartphone App To Manage Stress And Promote Resilience: A Qualitative Single Case Study, Beth Kelley, Kara Schacke, Alex Boggs, Shelley Blackwood

Wisdom & Compassion: The LUSON Journal

Stress is a detrimental factor in nursing school. Stressors contribute to an unacceptable nursing student attrition rate that has risen to 30% in 2021. The problem is that prelicensure, Bachelor of Science of Nursing (BSN) students' knowledge of mindfulness meditation using a smartphone app to manage stress and promote resilience is not known. Therefore, the purpose of this qualitative case study was to explore pre-licensure, BSN students’ knowledge of mindfulness meditation using a smartphone app to manage stress and promote resilience.

Jesus: The Multispecialty Health Care Provider, Rachel A. Joseph

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Children In Foster Care: Outcomes And Nursing Implications, Rachel A. Joseph, Emily Etterman

Wisdom & Compassion: The LUSON Journal

Background: Approximately 407,000 children remained in the foster care system by the end of 2020, with 217,000 entering and 224,000 exiting the system. The foster care system is meant to be a temporary living arrangement for children born into or raised in non-flourishing homes. However, the uniqueness of the system and the interactions of foster parents lead to undesirable foster home situations while the child is left in the system for longer times. The child in foster care faces several adverse life events that make it difficult for the child to develop into a successful adult. Purpose: This paper examines …

The Impact Of California's Nursing Licensure Policies On Patient Care During The Los Angeles Wildfires, Rachel A. Joseph

Wisdom & Compassion: The LUSON Journal

No abstract provided.

The Irreplaceable Role Of Human-Centered Nursing Care In The Age Of Ai, Allyson Louise Brown

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Volume 2, Issue 2 - Complete Issue

Wisdom & Compassion: The LUSON Journal

No abstract provided.

Stakeholders' Expectations And Experiences Of Being Involved With A Global Accreditation Process For Midwifery Centres In Lmics: A Rapid Ethnography, Summer M. Aronson, Laura Batinelli, Lucia Rocca-Ihenacho, Jennifer R. Stevens

College of Health Professions Faculty Papers

BACKGROUND: This study explored the expectations and experiences of stakeholders involved in the accreditation of midwifery centres (MCs) in low- and middle-income countries (LMICs). With increasing evidence that MCs provide safe, respectful, and evidence-based care that improves maternal and neonatal outcomes, accreditation may serve as a mechanism to bridge quality gaps in maternal health systems, particularly in regions with high maternal and neonatal mortality.

METHODS: A rapid ethnographic approach, combining participant observation and semi-structured interviews, was conducted in partnership with the GoodBirth Network (GBN), which identified six pilot midwifery centres in Haiti, Uganda, and South Africa. Convenience sampling was applied, …