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Full-Text Articles in Medicine and Health Sciences

Staff Education To Improve Patient Medication Adherence For Schizophrenia Using Long-Acting Injectables, Adela Ghogomu Dec 2025

Staff Education To Improve Patient Medication Adherence For Schizophrenia Using Long-Acting Injectables, Adela Ghogomu

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education initiative based on a comprehensive literature review that emphasized the importance of staff education in improving healthcare outcomes. The practice problem identified was a lack of staff knowledge and education regarding long-acting injectables (LAIs) in clients with schizophrenia, which contributed to inconsistent support for client medication adherence. It was essential to address this issue because nurses play a crucial role in medication management, patient education, and adherence support. The practice-focused question explored was: Will staff education regarding the use of long-acting injectables in clients with schizophrenia to enhance medication adherence improve …

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Reducing The Use Of Erythropoiesis-Stimulating Agents In Hemodialysis Patients, Myriamme Neree Dec 2025

Reducing The Use Of Erythropoiesis-Stimulating Agents In Hemodialysis Patients, Myriamme Neree

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a quality improvement (QI) initiative. Nephrologists were inconsistent in ordering iron studies and sometimes delayed the initiation of erythropoiesis-stimulating agents (ESAs) on admission to the inpatient site. These delays often led to suboptimal outcomes. The practice-focused question guiding the project asked whether a nurse-driven iron protocol would improve adherence to anemia management guidelines. The project’s purpose was to evaluate the impact of the evidence-based nurse-driven protocol. I used descriptive and inferential statistics for data analysis. Findings demonstrated a statistically significant improvement in the timely completion of iron studies and in intravenous (IV) iron …

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Staff Education To Improve Knowledge Of Probiotic Use And Benefits For Best Patient Outcomes, Rebecca M. Hoover Dec 2025

Staff Education To Improve Knowledge Of Probiotic Use And Benefits For Best Patient Outcomes, Rebecca M. Hoover

Walden Dissertations and Doctoral Studies

Abstract The staff education project to improve knowledge of probiotic use and benefits with antibiotic use, has shown to improve patient recovery and outcome. The post-implementation impact of the project is increased awareness of probiotic use and their benefits to prevent Antibiotic. Associated Diarrhea at the project site organization. I identified no limitations in the project. Staff education can be used worldwide to prevent digestive diseases with the use of probiotics supplements or probiotic food. Probiotics use is to improve patient outcomes by maintaining gut microbiome and digestive health. The evidence-based practice solution of a staff education on probiotic use …

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A Clinical Practice Guideline For Screening For Insomnia In College Students, Ashly Bliss Dec 2025

A Clinical Practice Guideline For Screening For Insomnia In College Students, Ashly Bliss

Walden Dissertations and Doctoral Studies

Insomnia and sleep deprivation are highly prevalent issues among the U.S. college student population, contributing to a significant health care gap due to the inconsistent performance of routine clinical screening. This Doctor of Nursing Practice (DNP) project sought to determine the rigor and applicability of a Clinical Practice Guideline (CPG) designed for the early identification of insomnia in college students using a best-evidence screening tool within a rural health clinic. The primary practice-focused question was: In a rural health clinic, will a CPG for implementation of a screening tool based on best evidence for early identification of insomnia in college …

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Impact Of Staff Education To Clinical Documentation Integrity Team, Leyna Belcher Dec 2025

Impact Of Staff Education To Clinical Documentation Integrity Team, Leyna Belcher

Walden Dissertations and Doctoral Studies

The doctoral project investigates the impact of education on Clinical Documentation Integrity (CDI) nurses in enhancing the accuracy and quality of clinical documentation within healthcare organizations. Clinical documentation plays a crucial role in accurately reflecting patient care and is essential for capturing proper diagnoses, coding, and reimbursement. In contrast, inaccurate or incomplete documentation can lead to misdiagnoses, poor patient outcomes, and financial deficits. Due to frequent updates in clinical guidelines and coding standards, CDI professionals require continuous, specialized training to stay informed with ever-changing medical terminology, disease processes, and coding regulations. By enhancing the CDI education, the aim is to …

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Early Depression Screening In Adults With Opioid Use Disorder, Ekaterina Versace Dec 2025

Early Depression Screening In Adults With Opioid Use Disorder, Ekaterina Versace

Walden Dissertations and Doctoral Studies

Abstract This Doctor of Nursing Practice project involved the development and quality appraisal of a clinical practice guideline (CPG) for early depression screening in adults with opioid use disorder (OUD), addressing the absence of standardized, evidence-based screening protocols in addiction treatment settings. Guided by the practice-focused question of whether existing evidence supports the development and evaluation of such a guideline using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, a systematic synthesis of 35 research articles was conducted, with 15 high-level studies informing guideline development. A multidisciplinary panel of four experts evaluated the CPG using the …

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Transition-To-Practice Program For Aprn Msn Graduates, Jennifer Nneoma Nwosu Dec 2025

Transition-To-Practice Program For Aprn Msn Graduates, Jennifer Nneoma Nwosu

Walden Dissertations and Doctoral Studies

The transition from graduate education to clinical practice marks a pivotal point in the professional journey of advanced practice registered nurses (APRNs). Despite rigorous preparation, many APRN MSN graduates struggle to adapt to the complex expectations of autonomous practice. The lack of structured mentorship, inconsistent orientation processes, and unclear performance expectations contribute to high stress, role confusion, and early turnover. This Doctor of Nursing Practice Executive Leadership project addressed this critical issue by evaluating whether an interprofessional team could achieve consensus on developing a best practice program to guide APRN MSN graduates’ transition to independent clinical practice. This initiative was …

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Staff Education To Impact Staff Knowledge Of Depression Screening In Primary Care, Nkeiruka Chinwendu Unaegbu Dec 2025

Staff Education To Impact Staff Knowledge Of Depression Screening In Primary Care, Nkeiruka Chinwendu Unaegbu

Walden Dissertations and Doctoral Studies

Summary This doctoral project was a staff education program designed to improve depression screening among patients in an adult primary care setting. The practice problem addressed was the lack of standardized depression screening that led to inconsistent detection, delayed diagnosis, and fragmented mental health care. A move to address the issue is critical in nursing practice since nurses play a central role in early identification, patient advocacy, and integration of behavioral health into primary care. The practice-focused question guiding the project was, Will implementing a nursing staff education program impact their knowledge of Clinical Practice Guideline (CPG) for depression screening …

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Factors Affecting School Readiness And Level Of Distraction Among Black Children During Virtual Learning In The United States, Imani Barnes Dec 2025

Factors Affecting School Readiness And Level Of Distraction Among Black Children During Virtual Learning In The United States, Imani Barnes

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic necessitated an shift to mandatory virtual learning (VL) for kindergarten through grade 12 students, disrupting educational systems globally and exposing systemic inequities. Although researchers had explored health and education disparities separately, they had not adequately examined the intersection of child health, specifically body mass index (BMI) and health-affected ability, with school readiness and level of distraction in VL environments. The purpose of this quantitative, cross-sectional study was to examine associations between BMI, health affected ability, school readiness, and distraction levels among U.S. Black children engaged in VL in the 2020 school year, controlling for gender, age, and …

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Healthcare Access, Economic Stability, And Food Security And Inflammatory Bowel Disease In Hispanic Adults Living In The United States, Jennifer Rodriguez Dec 2025

Healthcare Access, Economic Stability, And Food Security And Inflammatory Bowel Disease In Hispanic Adults Living In The United States, Jennifer Rodriguez

Walden Dissertations and Doctoral Studies

Hispanic adults in the United States experience disparities in chronic disease detection and outcomes, including inflammatory bowel disease (IBD). Social determinants of health (SDoH), including economic stability, healthcare access, and food security, play a crucial role in shaping health risks and diagnostic opportunities in this population. The purpose of this quantitative cross-sectional study was to examine the relationship between selected SDoH factors and self-reported IBD diagnosis among U.S. Hispanic adults. This study utilized survey data from the 2023 National Health Interview Survey (n = 29,457). Weighted descriptive statistics and logistic regression were used to analyze the relationships between variables while …

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Staff Education To Peri Operative Registered Nurses, Shahida P. Meghani Dec 2025

Staff Education To Peri Operative Registered Nurses, Shahida P. Meghani

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to enhance perioperative nursing adherence to evidence-based practices for preventing surgical site infections (SSIs). SSIs remain among the most prevalent healthcare-associated infections, affecting 2%–5% of surgical patients and contributing to extended hospital stays, higher costs, and preventable morbidity. The practice-focused question guiding this project was: In adult surgical patients, how does the implementation of a perioperative nursing education program on SSI prevention, compared to standard practice, affect SSI incidence rates over a 2- to 4-month period? The project applied the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to …

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Developing Nurse Knowledge And Confidence In Telehealth Delivery For Ptsd Care, Bisilola M. Yinusa Dec 2025

Developing Nurse Knowledge And Confidence In Telehealth Delivery For Ptsd Care, Bisilola M. Yinusa

Walden Dissertations and Doctoral Studies

With posttraumatic stress disorder (PTSD) prevalence increasing and telehealth becoming more integrated into mainstream healthcare practice, it is critical to ensure that nurses are adequately trained to deliver evidence-based, trauma-informed care through digital modalities. The identified practice problem centered on the limited telehealth competency among nurses, particularly in communication strategies, confidence, and clinical readiness for PTSD care via virtual platforms. This doctoral project was a staff education initiative designed to enhance the telehealth delivery of trauma-informed care for patients with PTSD. The purpose of this project was to evaluate whether the structured educational intervention improved nurses’ knowledge and confidence in …

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Staff Education On Burnout For Mental Healthcare Staff Mitigation Strategies For Psychiatric Outpatient Staff, Kadine Foreman-Westly Dec 2025

Staff Education On Burnout For Mental Healthcare Staff Mitigation Strategies For Psychiatric Outpatient Staff, Kadine Foreman-Westly

Walden Dissertations and Doctoral Studies

The purpose of this project is to determine whether implementing a staff education program in a psychiatric clinical setting can improve healthcare staff knowledge of strategies to prevent burnout. The project addresses a critical practice problem: a lack of structured education programs specifically targeting burnout recognition and management among mental healthcare staff. Burnout not only negatively impacts staff well-being but also affects patient safety and the overall quality of care. This project was designed to fill this gap by providing an educational intervention, with effectiveness measured through pre- and post-intervention surveys assessing staff knowledge. This staff education project was strengthened …

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Pregnancy Intention And Maternal Morbidity In Oklahoma And Mississippi: A Moderation Analysis Of Abortion Restriction Policies, Vicki Johnson Dec 2025

Pregnancy Intention And Maternal Morbidity In Oklahoma And Mississippi: A Moderation Analysis Of Abortion Restriction Policies, Vicki Johnson

Walden Dissertations and Doctoral Studies

More than half of all pregnancies are unintended (mistimed or unwanted), and women with unplanned pregnancies may face economic hardships for families and additional health consequences if they have pre-existing medical conditions. This quantitative study was conducted to examine the relationship between pregnancy intention levels and severe acute maternal morbidity, specifically chorioamnionitis, among women who gave birth in Oklahoma and Mississippi in 2022. Using secondary data (N=1939) from the Pregnancy Risk Assessment Monitoring System Automated Research Files and state-level abortion policy data from the Guttmacher Institute, this study employed Bronfenbrenner’s social ecological model framework to investigate the relationship between pregnancy …

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Clinical Practice Guideline On Reducing Catheter -Associated Urinary Tract Infections (Cautis), Nkechi Christiana Udah Dec 2025

Clinical Practice Guideline On Reducing Catheter -Associated Urinary Tract Infections (Cautis), Nkechi Christiana Udah

Walden Dissertations and Doctoral Studies

The project was a clinical practice guideline (CPG) for early catheter removal to prevent catheter-associated urinary tract infections (CAUTIs). At the project site, the practice gap was the surgical nurses’ nonadherence to clinical guidelines for reducing CAUTIs. This gap resulted in inconsistent catheter care practices and delays in catheter removal. The purpose of this CPG was to enhance surgical nurses’ knowledge and adherence to clinical guidelines for reducing CAUTI rates. The following practice-focused question guided the project: In hospitalized patients in acute care settings, does early removal of the urinary catheter compared to leaving the catheter until discharge reduce the …

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Staff Education For Enhancing Providers’ Knowledge Of Long Acting Injectables (Lais) Antipsychotics In The Outpatient Mental Health Clinic, Belinda Okoruwa Dec 2025

Staff Education For Enhancing Providers’ Knowledge Of Long Acting Injectables (Lais) Antipsychotics In The Outpatient Mental Health Clinic, Belinda Okoruwa

Walden Dissertations and Doctoral Studies

This doctoral study is a quality-improvement educational program in an outpatient mental health clinic designed to address the underutilization of long-acting injectable (LAI) antipsychotics due to gaps in providers’ knowledge. The project question centered on whether structured education on LAIs antipsychotics increases providers’ knowledge in an outpatient mental health setting. The purpose of this project is to increase LAI antipsychotic utilization by educating providers about the advantages, safety, and appropriate administration to promote consistent implementation. In this project, I used a single-group pre/post design including six participants, incorporating a 12-item questionnaire and 5-point Likert scale questions (Not at all/Somewhat/Very Much). …

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Social And Contextual Factors Influencing Hypertension Among Latino Men Living In California, Leslie Ivett Ortega Dec 2025

Social And Contextual Factors Influencing Hypertension Among Latino Men Living In California, Leslie Ivett Ortega

Walden Dissertations and Doctoral Studies

Hypertension remains a critical and often silent public health issue that disproportionately affects Latino men in California. This quantitative, retrospective cross-sectional study explored the social and contextual factors influencing hypertension among this vulnerable population. Using the 2019 Behavioral Risk Factor Surveillance System dataset, which included a sample size of 2,060 participants, the study examined the relationship between hypertension and key variables including primary care utilization, health insurance, smoking, physical activity, mental health, and marital status, while controlling for age, education, and income. Guided by the health belief model, binary logistic regression analyses found health insurance and primary care utilization significantly …

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Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah Dec 2025

Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah

Walden Dissertations and Doctoral Studies

Abstract In Ghana, the user fee exemption policy, implemented in 2008, provides free maternal health services, which are a key component of the National Health Insurance Scheme (NHIS). Grounded in the Health Access Livelihood Framework, the purpose of this study was to determine the association between the user fee exemption policy and the utilization of antenatal care, facility-based delivery, and postnatal care in Northern Ghana, while controlling for sociodemographic factors. A quantitative approach was employed using secondary data from the Ghana Demographic and Health Surveys, encompassing women of reproductive age (15–49 years; N = 6,948). Logistic regression was used to …

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Staff Education To Improve Nursing Knowledge On Fall Prevention, Mary Del Riffe Dec 2025

Staff Education To Improve Nursing Knowledge On Fall Prevention, Mary Del Riffe

Walden Dissertations and Doctoral Studies

Summary Falls in health care facilities constitute the most prevalent incidents among all safety-related mishaps. If unaddressed, falls can result in severe consequences and perhaps fatal outcomes for patients. The Doctor of Nursing practice (DNP) project was developed to address the issue of patient falls in a long-term acute care hospital (LTACH). The practice-focused question was: Will implementation of an educational evidence-based staff fall prevention program improve nurses’ knowledge on fall prevention? The 1-hour staff education program was created based on review of recent evidence. Twelve nurses attended the staff education program. A pre- and posttest were used to evaluate …

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Metabolic Screening In Veterans On Antipsychotics Mood Stabilizer, Joy Nneka Eke Dec 2025

Metabolic Screening In Veterans On Antipsychotics Mood Stabilizer, Joy Nneka Eke

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was conducted to examine a quality improvement initiative that sought to address metabolic syndrome screening consistency for veterans on antipsychotic medications at a U.S. Department of Veterans Affairs health system located in the Midwest region of the United States. The project centered on whether the quality improvement program assessing compliance with the current metabolic syndrome screening process reflects increased early detection of metabolic syndrome to prevent cardiovascular complications. Data collection involved comprehensive chart reviews of 50 veterans’ records. The data collected were analyzed using a specially designed quality improvement initiative assessment form developed …

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Executive Summary: Executive Leadership System Improvement Workplace Violence, Mercedes Ivette Tejada Dec 2025

Executive Summary: Executive Leadership System Improvement Workplace Violence, Mercedes Ivette Tejada

Walden Dissertations and Doctoral Studies

Introduction This Doctor of Nursing Practice (DNP) Executive Leadership Project is focused on the reduction of workplace violence in a critical access hospital using an organized prevention program. Workplace violence in nursing is increasing, exposing the health of staff, patient safety, and quality of care in critical access hospitals. The question of the DNP project is: In nurses (P) in small critical access hospitals, how does implementing a structured workplace violence prevention program (I) compared to having no formal violence prevention strategy (C) impact the occurrence of workplace aggression and perceptions of safety among staff (O)? This practicum project used …

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Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin Dec 2025

Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin

Walden Dissertations and Doctoral Studies

Pet ownership continues to be part of modern society in the United States. Researchers have explored pet ownership’s impact on chronic diseases and aging populations, but research on health-related quality of life is limited. Grounded in the socioecological model, this quantitative study analyzed data from the 2005-2006 National Health and Nutrition Examination Survey (N = 10,348) to investigate the impact of pet ownership on health-related quality of life among low-income adults aged 30-50 years. Chi-square tests were performed to analyze the associations between age, income, gender, and race with three health-related quality of life metrics. Results showed no statistically significant …

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Preventing Psychotropic Medication Duplication: Improving Communication Between Primary Care And Psychiatric Providers, Linda Nwachuku Dec 2025

Preventing Psychotropic Medication Duplication: Improving Communication Between Primary Care And Psychiatric Providers, Linda Nwachuku

Walden Dissertations and Doctoral Studies

This project is an education-based initiative designed to address the persistent problem of psychotropic medication duplication in integrated care settings. Duplication occurs when patients receive multiple prescriptions of the same or similar psychotropic drugs. The practice gap exposes patients to adverse drug events, complications of polypharmacy, and reduced adherence, and subjects the providers to liability. The practice-focused question guiding this project is: For primary care and psychiatric providers, will an education program on structured communication and medication reconciliation, compared to current usual practices, increase provider confidence and awareness of the risks of duplication, communication strategies, and increased the use of …

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Staff Education To Implement Phq-9 Depression Screening Among Adults, Sharon C. Nwanne-Temple Dec 2025

Staff Education To Implement Phq-9 Depression Screening Among Adults, Sharon C. Nwanne-Temple

Walden Dissertations and Doctoral Studies

Abstract Depression remains one of the most prevalent and underdiagnosed mental health conditions globally, resulting in substantial morbidity, diminished quality of life, and increased healthcare costs. The purpose of this Doctor of Nursing Practice (DNP) project was to improve early detection of depression among adults in a primary care setting through a structured staff education program on the use of the Patient Health Questionnaire-9 (PHQ-9) screening tool. A mixed-methods quality improvement design guided implementation over a six-week period with nine clinical staff participants, including nurses, medical assistants, and providers. The educational intervention comprised a PowerPoint presentation, interactive discussion, and post-training …

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Improving Patient Access To Providers By Optimizing Message Center Workflow, Serena Valino Dec 2025

Improving Patient Access To Providers By Optimizing Message Center Workflow, Serena Valino

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement initiative that addressed the practice problem of having large volumes of unanswered messages within the patient portal. To increase patient access to the healthcare provider, a literature search was conducted using the practice-focused question: Can standardization of patient portals improve the message turnaround time? In January 2024, a scoping review of nursing message center pools determined 79 pools lacked standardized names and established workflows for 37 ambulatory clinics. Pool names were identified for each clinic and listed using an Excel spreadsheet. Clinic pool members were isolated, and it was determined by …

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Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards Nov 2025

Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is associated with significant health complications, including stroke, myocardial infarction, heart failure, and kidney disease. Despite advances in the treatment and management of HTN, a lack of medication adherence contributes to the persistence of HTN-related morbidity and mortality affecting men in The Bahamas. The purpose of this qualitative descriptive phenomenological study, guided by Pender’s health promotion model and Bandura’s social cognitive theory, was to explore the lived experiences of Bahamian men diagnosed with hypertension regarding their adherence to prescribed medications. Using Giorgi’s descriptive phenomenological method, in-depth, semistructured interviews were conducted with 11 participants. Data were analyzed through repeated …

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Impact Of Community Factors On Naloxone Overdose Reduction In Ohio, Theophilus Oduro Frimpong Nov 2025

Impact Of Community Factors On Naloxone Overdose Reduction In Ohio, Theophilus Oduro Frimpong

Walden Dissertations and Doctoral Studies

The opioid crisis in Ohio, driven by fentanyl, persists due to inequitable access to naloxone despite its proven effectiveness. This study examined how socioeconomic status (SES), race/ethnicity, population density, and hospital availability per capita predicted naloxone overdose reversals (dependent variable) in Ohio. Social-ecological theory guided this quantitative historical correlational analysis of Ohio’s Project DAWN index data (N = 5,280). Inclusion criteria included individuals ages 18 to 65 with naloxone-related overdose reversals (dependent), naloxone distribution (moderator), and community factors (independent). Multiple linear regression results showed that SES (p >.50), race/ethnicity (% White, p = .588; % Black, p = .495; % …

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Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu Nov 2025

Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a …

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Psychopharmacologic Management Of Serious Mental Illness In State Prisons, Clarel Neuvieme Nov 2025

Psychopharmacologic Management Of Serious Mental Illness In State Prisons, Clarel Neuvieme

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project focused on developing and evaluating an evidence-based clinical practice guideline (CPG) for the psychopharmacologic management of serious mental illness (SMI) in a state correctional health system. The project explored a critical practice gap: the unavailability of standardized, evidence-based prescribing and monitoring protocols for incarcerated individuals diagnosed with schizophrenia, major depressive disorder with psychotic features, or bipolar disorder. The evidence-based project was structured around the central question: “Will an interprofessional team achieve consensus on updating the clinical practice guideline for psychopharmacologic management of serious mental illness in state prisons, thereby improving consistency and quality …

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Development Of Evidence-Based Clinical Practice Guidelines For Monitoring Diabetic Patients Using Smartphone Technology, Ganiyat Funmilayo Efuntoye Nov 2025

Development Of Evidence-Based Clinical Practice Guidelines For Monitoring Diabetic Patients Using Smartphone Technology, Ganiyat Funmilayo Efuntoye

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed and validated an evidence-based clinical practice guideline for implementing smartphone technology to monitor diabetic patients in primary care settings with an 80% threshold. The project addressed a critical gap in standardized guidance for diabetes technology integration, which has resulted in inconsistent adoption and suboptimal patient outcomes. A systematic literature review of four major databases yielded 12 high-quality studies representing all evidence levels (I–V) according to the Johns Hopkins evidence-based practice model. Evidence synthesis revealed strong and compelling evidence with consistent results supporting smartphone technology implementation, including HbA1c improvements of 0.4%–0.8%, sustained patient engagement rates …

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