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Articles 361 - 390 of 5875
Full-Text Articles in Medicine and Health Sciences
Examining Predictors For Surgical Site Infection Following Abdominal Hysterectomy Among Women In New York, Nicole Henry
Examining Predictors For Surgical Site Infection Following Abdominal Hysterectomy Among Women In New York, Nicole Henry
Walden Dissertations and Doctoral Studies
Surgical site infections (SSIs) remain one of the most frequent and preventable complications following abdominal hysterectomy. Existing literature has focused on clinical and procedural risk factors, while less is known about how social conditions shape surgical outcomes. This gap is especially concerning for women in New York State (NYS) where differences in income, marital status, primary payer, rurality, and county-level food insecurity may influence postoperative outcomes and subsequent care. The socioecological model provided the foundation for this retrospective cohort study by examining how social drivers of health (SDoH) are associated with SSI incidence following abdominal hysterectomy, and whether food insecurity …
U.S. Pharmacists’ Perceptions Of Getting The Covid-19 Vaccine And How That Affects Their Interactions With The Public, Megan Boals
U.S. Pharmacists’ Perceptions Of Getting The Covid-19 Vaccine And How That Affects Their Interactions With The Public, Megan Boals
Walden Dissertations and Doctoral Studies
Pharmacists play a pivotal role in public health, particularly in promoting vaccination. However, vaccine hesitancy among pharmacists significantly undermines their willingness to provide effective patient counseling and to advocate for vaccination, potentially eroding public trust in vaccines. This descriptive-phenomenological study sought to understand the factors contributing to pharmacists’ COVID-19 vaccine hesitancy and how this hesitancy affected their willingness to recommend vaccines to patients. Twenty practicing pharmacists were interviewed via Zoom between September 23 and October 14, 2025. The health belief model helped interpret the study findings. Thematic analysis, as described by Braun and Clarke, was conducted to identify and interpret …
Implementing An Acuity-Based Staffing Model To Improve Staffing Equity And Patient Safety In An Inpatient Mental Health Unit, Vivian Emuobe
Implementing An Acuity-Based Staffing Model To Improve Staffing Equity And Patient Safety In An Inpatient Mental Health Unit, Vivian Emuobe
Walden Dissertations and Doctoral Studies
Understaffing during the weekends has been related to issues in patient safety, delayed responses, and increased nurse fatigue and turnover in a majority of inpatient mental health units. This practice improvement Doctor of Nursing Practice (DNP) project aimed to address disparities in nurse staffing ratios between weekdays and weekends within inpatient mental health units. The purpose of the project was to design and test an evidence-based acuity-based staffing model, supported by structured staff education and compliance monitoring, to promote equitable workload distribution and improve patient and organizational outcomes. The guiding practice question asked: How does the implementation of an acuity-based …
Enhancing Staff Education For Remote Blood Pressure Monitoring In Rural Clinics, Judi Brown Brown
Enhancing Staff Education For Remote Blood Pressure Monitoring In Rural Clinics, Judi Brown Brown
Walden Dissertations and Doctoral Studies
This is an educational intervention project targeted was developed to fill a knowledge gap in the treatment of hypertension in a rural primary care clinic. The project focused on enhancing staff education for Remote Blood Pressure Monitoring (RBPM) to enhance the desired patient outcomes regarding continuous monitoring and early interventional actions. The practice problem focuses on the lack of effective methods in managing hypertension that can facilitate the identification of hypertensive crisis and in rural areas. This project's primary research question is: "How can staff education on RBPM enhance knowledge and skills about hypertension management in rural clinics?" The project …
Assessing Type 2 Diabetes Mellitus, Christine A. Mccaulay
Assessing Type 2 Diabetes Mellitus, Christine A. Mccaulay
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice capstone project presents the development and evaluation of a clinical practice guideline (CPG) for the assessment and management of Type 2 Diabetes Mellitus in adults. The project addresses the ongoing challenge of diabetes-related complications and hospitalizations, highlighting the critical role of personalized patient education and the integration of smartphone technology for home monitoring. Central to this initiative was the question of whether an expert panel would endorse an evidence-based guideline for diabetes monitoring using innovative technology, as evaluated by the AGREE II tool. A robust review of the literature supported the guideline’s development, with high-quality …
Reducing Social Isolation In Elderly Hospice Patients Through Structured Social Interventions, Ashley Babayan
Reducing Social Isolation In Elderly Hospice Patients Through Structured Social Interventions, Ashley Babayan
Walden Dissertations and Doctoral Studies
This doctoral project was conducted as a quality improvement organizational change initiative aimed at reducing social isolation among elderly hospice patients through structured social interventions. Social isolation is a significant psychosocial concern in hospice populations and is associated with increased emotional distress, depression, and decreased quality of life. Despite hospice care’s holistic philosophy, structured and standardized social engagement interventions are inconsistently implemented across settings, creating a gap in practice. The practice-focused question guiding this project was: In elderly hospice patients experiencing social isolation, how do structured social interventions (regular visits, group activities, and emotional support systems), compared to standard hospice …
Evaluation Of Nurses' Leadership Self-Efficacy In Belize, Ruth Rosalee Reina Jones
Evaluation Of Nurses' Leadership Self-Efficacy In Belize, Ruth Rosalee Reina Jones
Walden Dissertations and Doctoral Studies
Nursing leadership in Belize is lacking but crucial to the well-being of patients, families, and the healthcare team. The purpose of this non-experimental, descriptive, comparative study was to a) determine the difference in leadership self-efficacy for current nurse leaders with three years or less of leadership experience compared to current nurse leaders with more than three years of leadership experience in Belize, and b) examine the differences in leadership self-efficacy between nurses in a leadership position and nurses not in a leadership position in Belize. The theories supporting the study were Burns’ transformational leadership theory and leadership self-efficacy, based on …
Anxiety, Cognitive Load, And Simulation Effectiveness In Pre-Licensure Bsn Students, Brittany Behrens
Anxiety, Cognitive Load, And Simulation Effectiveness In Pre-Licensure Bsn Students, Brittany Behrens
Walden Dissertations and Doctoral Studies
High-fidelity simulation experiences are an integral component of pre-licensure nursing curricula, providing students with realistic, controlled environments to develop clinical judgement skills. While these simulations enhance learning, they can increase anxiety and cognitive load, potentially impairing students’ ability to process information and derive meaningful outcomes. The purpose of this quantitative, correlational study was to examine the relationships among pre-simulation anxiety, cognitive load, and perceived simulation effectiveness in pre-licensure BSN students. Data were collected from 90 participants using the shortened Spielberger State-Trait Anxiety Inventory (STAI), the Cognitive Load Measurement–Naïve Rating Questionnaire, and the Simulation Effectiveness Tool–Modified (SET-M). Pearson correlation analyses indicated …
Improving Depression Screening For African American Adolescents Through Staff Education On The Phq-A, Yvonne Anutatu Nkeze
Improving Depression Screening For African American Adolescents Through Staff Education On The Phq-A, Yvonne Anutatu Nkeze
Walden Dissertations and Doctoral Studies
Improving Depression Screening for African American Adolescents Through Staff Education on the PHQ-A
Implementing Staff Education To Improve Depression Detection In Primary Care Using Patient Health Questionnaire (Phq-9), Ukamaka Okeke
Implementing Staff Education To Improve Depression Detection In Primary Care Using Patient Health Questionnaire (Phq-9), Ukamaka Okeke
Walden Dissertations and Doctoral Studies
This staff education project focuses on improving depression detection in a primary care settings using Patient Health Questionnaire (PHQ-9) screening tool. Depression is a leading cause of disability worldwide, requiring reliable and adaptable screening tools. The diagnosis of depression is one of the most common mental health disorders in primary care but is poorly identified and frequently missed. The lack of consistent screening for depression among patients often results in delayed identification of symptoms, which postpones early treatment, increasing the risk of complications associated with untreated depression. The practice site identified that depression screening was frequently missed during patient intake, …
Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse
Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse
Walden Dissertations and Doctoral Studies
Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …
Examining Undergraduate Nursing Faculty’S Job Satisfaction Related To Workload, Work-Life Balance, And Student Incivility, Melissa Walch
Examining Undergraduate Nursing Faculty’S Job Satisfaction Related To Workload, Work-Life Balance, And Student Incivility, Melissa Walch
Walden Dissertations and Doctoral Studies
Exploring nursing faculty job satisfaction is important for retaining faculty in undergraduate nursing programs because they are vital to training future bedside nurses. There is a nursing faculty shortage in the United States, and retaining faculty is critical to addressing it. The purpose of this study, guided by Herzberg’s motivation-hygiene theory, was to (a) understand the relationship between workload, work-life balance, and nursing faculty job satisfaction and (b) the relationship between student incivility and nursing faculty job satisfaction in undergraduate nursing programs. Undergraduate nursing faculty in Ohio and Florida with at least 2 years of teaching experience were recruited via …
Enhancing Staff Knowledge And Confidence In Depression Screening Using The Patient Health Questionnaire-9, Melkamzer Chari
Enhancing Staff Knowledge And Confidence In Depression Screening Using The Patient Health Questionnaire-9, Melkamzer Chari
Walden Dissertations and Doctoral Studies
Depression is a serious public health concern affecting over 280 million people globally and leading to significant morbidity and mortality if left undetected and untreated. At the local organization, leadership identified inconsistent depression screening as a practice problem among nursing staff. Thus, the purpose of this doctor in nursing practice (DNP) project was to determine if an educational intervention focused on depression, the importance of depression screening, and the use of the Patient Health Questionnaire-9 (PHQ-9) increased knowledge and confidence among nursing staff working in a local organization. Fifteen participants volunteered to participate in the project. The average age was …
Enhancing Staff Education On Antidepressant Side Effects For Adolescents At Discharge, Mingdi Gao
Enhancing Staff Education On Antidepressant Side Effects For Adolescents At Discharge, Mingdi Gao
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) evidence-based staff education project aimed to improve the quality and consistency of discharge medication education for adolescents prescribed antidepressants. Adolescents are at increased risk for antidepressant-related adverse effects, including suicidal ideation, particularly during the early stages of treatment. The identified practice problem was the lack of consistent, developmentally appropriate, and culturally sensitive discharge teaching for adolescents and their families. This gap in practice contributes to poor adherence, preventable readmissions, and diminished safety outcomes. The project was guided by the PICO question: For adolescents discharged from inpatient or outpatient behavioral health care, how does a …
Staff Education To Improve Nurse Confidence In Managing Co-Occurring Conditions, Gloria Johnston
Staff Education To Improve Nurse Confidence In Managing Co-Occurring Conditions, Gloria Johnston
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) staff education project addressed a lack of confidence and training for nursing staff who care for patients with co-occurring substance use and mental health disorders. The practice problem identified at the local project site was the inconsistent care of this patient population. Addressing this gap was essential because inadequate training can reduce care quality among patients with co-occurring conditions. The practice-focused question for this project was: In nursing staff caring for patients with co-occurring mental health and substance use disorders, how does an evidence-based staff education program on integrated treatment approaches compare to standard …
Staff Education To Optimize Pain Management In Home Health Care, Marie Natacha Francis
Staff Education To Optimize Pain Management In Home Health Care, Marie Natacha Francis
Walden Dissertations and Doctoral Studies
This DNP project is a nurse-led quality improvement initiative that responds to the age-old issue of ineffective pain management in the home healthcare setting. The issue is the absence of standardization in staff education regarding pain assessment and intervention, leading to unfavorable patient outcomes and a reduced quality of life. The purpose of the project is to assess the efficacy of educational interventions delivered by nurses to enhance staff knowledge, confidence, and consistency in the management of pain procedures. The project question is: How effective are nurse-led educational interventions in improving staff knowledge and practices in pain assessment and management, …
Staff Education To Improve Nurses’ De-Escalation Skills In Substance Abuse Treatment Settings, Joy Atufunwa
Staff Education To Improve Nurses’ De-Escalation Skills In Substance Abuse Treatment Settings, Joy Atufunwa
Walden Dissertations and Doctoral Studies
Nearly 50% of patients in substance abuse treatment settings exhibit aggressive behaviors, placing staff and other patients at risk. In the absence of structured de-escalation training, clinicians frequently rely on physical restraints or pharmacologic interventions, which contribute to staff burnout, injury, and ethical concerns. The project implemented an evidence-based staff education program to improve nurses’ knowledge, confidence, and competence in managing aggression using nonviolent de-escalation strategies. The project question guiding this initiative was: Can education improve nurses’ de-escalation skills in a substance abuse treatment setting? Using an evidence-based practice (EBP) approach and the PICO framework, the project evaluated the impact …
Quality Of Prenatal Care, Provider Preference, And Preeclampsia Among African American Women In Georgia, Lyteasha Bass
Quality Of Prenatal Care, Provider Preference, And Preeclampsia Among African American Women In Georgia, Lyteasha Bass
Walden Dissertations and Doctoral Studies
African American women experience disproportionately high rates of preeclampsia in the United States; however, the contributions of prenatal care provider type, health care access, and quality of care to this disparity were insufficiently defined. Guided by the quality health outcomes model, this quantitative case-control study used primary data to examine associations between these factors and the occurrence of preeclampsia among African American women age 18–40 who had given birth within the previous 5 years in Georgia. Descriptive statistics and binary and multinomial logistic regression analyses were conducted. Prenatal care quality was measured using the Quality of Prenatal Care Questionnaire (QPCQ), …
Communication Challenges Experienced By Telephone Triage Registered Nurses Providing Assessment Of Health Symptoms, Stacy Huddleston
Communication Challenges Experienced By Telephone Triage Registered Nurses Providing Assessment Of Health Symptoms, Stacy Huddleston
Walden Dissertations and Doctoral Studies
Telephone triage nurses routinely assess symptoms and make clinical decisions without visual contact, which introduces complex communication challenges. Language differences, emotional distress, cultural misunderstandings, and the absence of visual cues may influence how symptoms are described, interpreted, and acted upon during telephone encounters. The purpose of this qualitative interpretive description study, guided by Peplau’s theory of interpersonal relations, was to explore how RNs experience and manage communication barriers in telephone triage practice. Six RNs with recent experience in telephone triage participated in semistructured interviews, and the data were analyzed using interpretive description and thematic analysis. Findings indicated that participants relied …
Health Histories, Tiffanie Walton
Health Histories, Tiffanie Walton
Walden Dissertations and Doctoral Studies
No abstract provided.
Staff Education For Prevention And Management Of Obesity In Adolescents From Underserved Communities, Doris Mtarubukwa
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
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 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 On Phq-9 To Improve Depression Screening And Patient Outcomes, Ahmad Ghandour
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 …
Staff Education For Hypertension Diagnosis, Management, And Treatment, Philomena Ifeyinwa Chinemelu
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
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.
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, …
A Nurse-Led Clinical Practice Guideline To Improve Medication Adherence Among Psychiatric Home-Health Patients, Amber Murillo - Alonzo
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 …
Management Of Alcohol Withdrawal Syndrome In The Emergency Department, Janet Fuller
Management Of Alcohol Withdrawal Syndrome In The Emergency Department, Janet Fuller
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project involved development and approval of a clinical practice guideline (CPG) for management of alcohol withdrawal syndrome (AWS) in the emergency department (ED) of a large community trauma center in the southeastern United States. AWS is a common, potentially life-threatening condition requiring timely assessment and intervention to prevent. Variability in ED screening and treatment contributes to delayed intervention, increased rapid response activations, and intensive care transfers. The project purpose was to develop and obtain expert approval of an evidence-based CPG using the Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) tool to support standardized screening, symptom-triggered …
Staff Education On Evidence-Based Interventions To Improve Patient Engagement In An Outpatient Mental Health Clinic, Gloria Egeh
Staff Education On Evidence-Based Interventions To Improve Patient Engagement In An Outpatient Mental Health Clinic, Gloria Egeh
Walden Dissertations and Doctoral Studies
In this project, I implemented a staff education initiative at an outpatient psychiatric facility in Michigan to address gaps in clinicians’ and office managers’ knowledge of evidence-based patient engagement strategies. Limited understanding had hindered patient participation in treatment planning, symptom self-management, and shared decision-making, key components of recovery-oriented care. The education initiative was aimed at enhancing staff competencies to strengthen therapeutic alliances, improve treatment adherence, and support positive mental health outcomes. Guided by a practice-focused question, in the project I examined whether an evidence-based staff education program would improve patient engagement among adults receiving outpatient mental health services. A pre-/postintervention …