Medicine and Health Sciences Commons^™

Assault Vs. Assistance: Radiologic Technologist Decision-Making When Fall-Risk Patients Decline Assistance, Pamela O'Dowd

Radiologic Sciences

Purpose To explore how radiologic technologists experience and respond to situations involving fall-risk patients who decline assistance during imaging procedures.

Method A cross-sectional survey design was used to collect data from practicing radiologic technologists recruited through the American Society of Radiologic Technologists. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS to summarize participant responses, and a thematic analysis was conducted on open-ended responses.

Results A total of 87 respondents completed the survey. Results indicated that encounters with fall-risk patients who refuse assistance are common in clinical imaging practice. Sixty-three (72.4%) technologists reported having experienced situations in which a …

Magnetic Resonance In Pregnancy: Safety Considerations, Contrast Risks, And Imaging Modality Alternatives, Lizzette Valdez

Radiologic Sciences

Purpose To examine the safety of magnetic resonance (MR) during pregnancy by evaluating fetal outcomes, contrast agent risks, and the comparative roles of MR, ultrasound, and computed tomography (CT) in prenatal imaging.

Method A literature review was conducted using PubMed and peer-reviewed radiology journals to identify studies evaluating MR safety during pregnancy. The review examined fetal and neonatal outcomes following prenatal MR exposure, trimester-specific imaging considerations, risks associated with gadolinium-based contrast agents, and comparisons among MR, ultrasound, and CT.

Results Three primary themes emerged: (a) noncontrast MR demonstrated a strong safety profile with no consistent association with adverse fetal or …

Comparing Ai-Generated And Human-Written Radiology Reports: Evidence From The Literature, Lakenya Webb

Radiologic Sciences

Purpose To evaluate the current evidence comparing artificial intelligence (AI)-generated radiology reports with radiologist-written reports, emphasizing diagnostic accuracy, clinical reasoning, workflow efficiency, and patient safety.

Method A literature review was performed using peer-reviewed articles identified through The University of Texas MD Anderson Cancer Center Research Medical Library. Studies evaluating AI-generated radiology reports were analyzed using AI-assisted thematic synthesis to identify recurring patterns related to report quality, diagnostic performance, and clinical implementation.

Results The literature consistently identified three overarching themes: (a) AI-generated reports demonstrated improvements in structured reporting and factual consistency but exhibited variable diagnostic accuracy; (b) current AI systems had …

Deep Learning Reconstruction In Pediatric Ct Imaging, Cody Wyatt

Radiologic Sciences

Purpose To synthesize current evidence on dose optimization using deep learning reconstruction (DLR) with emphasis on computed tomography (CT), pediatrics, contrast to noise ratio (CNR), signal to noise ratio (SNR), and radiation dosage.

Method The methodology was a systematic literature review, synthesizing peer-reviewed literature on the use of DLR in pediatric CT. Databases searched included Scopus, IEEE Xplore, and Web of Science. Keywords include combinations of deep learning reconstruction, DLR, CT, pediatric, dose, and optimization. Boolean operators were used to refine search results.

Results Three themes emerged: dosage reduction, noise reduction, and improved spatial resolution with the use of DLR …

National Pacs And Electronic Health Records: Considerations, Challenges, And Implications For Radiomics, Darchelle Scott

Radiologic Sciences

Purpose To examine the considerations, challenges, and implications of implementing a national picture archiving and communication system (PACS) integrated with electronic health records (EHRs), with particular emphasis on interoperability, radiomics, and patient-centered data sharing.

Method A systematic literature review was conducted using books, peer-reviewed articles, original research studies, and government publications addressing radiomics, TEFCA, blockchain technology, PACS, and EHR integration. Literature was analyzed to evaluate national health information exchange, radiomics applications, and implementation challenges associated with a connected healthcare infrastructure.

Results Three primary themes emerged: (a) interoperable national PACS and EHR systems have the potential to improve continuity of care …

Quality Improvement Project: Experienced Nurse To Novice Adjunct Educator: Bridging The Gap, Karen Liddy

Doctor of Nursing Practice Projects

A formal mentoring program is an effective approach for enhancing mentee satisfaction and self-efficacy and decreasing turnover rates. Although evidence supports the benefits of mentoring, many universities lack formal mentoring programs for adjunct faculty. Utilizing the PDSA framework, this quality improvement Doctor of Nursing Practice (DNP) project executed and evaluated a structured adjunct faculty mentoring program to improve faculty self-efficacy and mentee satisfaction. The project was led by Bandura's Social Cognitive Theory and the Theory of Change and used a pre- and post-test design involving adjunct nursing faculty members with fewer than three years of academic teaching experience. Mentors and …

Improving Implementation Of The Cmqcc Obstetric Hemorrhage Risk Assessment Tool To Improve Maternal Hemorrhage Response And Outcomes, Emily Hobbs, Karla Beiswenger

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to …

Evaluation Of Unconventional Bolus Materials For Radiation Therapy: A Study Of Sand, And Rice, Brooke Benson

Masters Projects

Abstract

Purpose: Research easily accessible substitutes for Superflab which conform better to the patient surface and are more conformal in an attempt to increase efficacy of bolus for clinical use.

Methods: For this experiment, sand and rice were measured based on Hounsfield units (HU) and relative electron density (RED) and placed into bags to be formed to a patient surface, securing their shape through the use of a vacuum sealer. After repeated CT scans with the chosen materials, plans were calculated on each scan followed by measurement of HU, air gap volume, bolus volume, and dosimetric parameters including monitor units …

Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …

Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …

Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso

Walden Dissertations and Doctoral Studies

The transition from student nurse to professional practice remains a vulnerable period marked by role ambiguity, stress, and early turnover. At a large medical center, the lack of a structured bridge between the final capstone experience and the residency program contributed to inconsistent onboarding, reduced confidence, and diminished resilience among new graduates. Addressing this gap is essential for strengthening retention, supporting workforce stability, and improving patient outcomes within nursing practice. An evidence‑based clinical practice guideline (CPG) outlining best‑practice recommendations for a new graduate transition program from capstone to residency was developed for the facility. The practice‑focused question asked whether the …

Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape

Walden Dissertations and Doctoral Studies

Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% …

Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa

Walden Dissertations and Doctoral Studies

Pressure injuries that patients develop while hospitalized continue to be a major safety concern in hospitals treating very sick patients. These wounds hurt, make infections more likely, keep people in the hospital longer, and increase expenses. On many units, the steps meant to stop these injuries, like checking each patient's risk level and turning patients regularly are not carried out the same way for everyone. Because of this inconsistency, some patients develop preventable pressure injuries. The purpose of this Doctor of Nursing Practice (DNP) project was to create a clinical practice guideline (CPG) for organized pressure injury prevention and to …

Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala

Walden Dissertations and Doctoral Studies

Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …

Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …

Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise

Walden Dissertations and Doctoral Studies

Delirium is a preventable and manageable neuropsychiatric condition characterized by acute fluctuations in attention, awareness, and cognition. The burden of this acute confusion syndrome among older adults aged > 65 years is disproportionate higher, due to age-related neurocognitive vulnerabilities. Nurse-led delirium prevention interventions can reduce incidence from 70% to 20% following structured education, gaps persist in nursing knowledge around evidence-based prevention strategies. The purpose of this project was to evaluate whether a structured nursing education intervention on enhanced mobility and sensory aid optimization strategies, as components of the ABCDEF bundle, improved nursing knowledge compared to standard care practices. Nineteen registered nurses …

Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …

Reducing No-Show Rates In An Outpatient Behavioral Health Clinic Through A Multimodal Patient Engagement Intervention, Gwendoline Osong

Walden Dissertations and Doctoral Studies

Reducing No-Show Rates in an Outpatient Behavioral Health Clinic Through a Multimodal Patient Engagement Intervention

Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger

Walden Dissertations and Doctoral Studies

Social determinants of health (SDOH) significantly influence health outcomes, yet many primary care organizations lack a standardized, evidence-based process for identifying patients' social needs and facilitating referrals to appropriate community resources. The purpose of this Doctor of Nursing Practice executive leadership project was to develop and implement a clinical practice guideline (CPG) to standardize SDOH screening and social services referrals in a primary care setting. The practice-focused question asked whether a CPG designed to standardize social services referrals would be approved by a panel of subject matter experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. …

Staff Education To Improve Staff Knowledge, Confidence, And Competency In The Use Of The Zung Self-Rating Depression Scale, Theresa Buabeng

Walden Dissertations and Doctoral Studies

Staff Education to Improve Staff Knowledge, Confidence, and Competency in the Use of the Zung Self-Rating Depression Scale

Improving Medication Adherence Through Structured Telephone Follow-Up To Reduce 30-Day Readmissions Among Adult Patients With Heart Failure, Angela Dean Hamilton

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) evidence-based quality improvement (QI) project addressed high 30-day hospital readmission rates among adults with heart failure (HF), a problem associated with poor medication adherence and inadequate transitional care that nurses are uniquely positioned to address through discharge education, medication reconciliation, and postdischarge follow up to improve patient safety and quality of care. The practice-focused question asked: In adult patients discharged with HF, how does a structured, nurse-led, telephone follow-up intervention focused on medication adherence, compared with usual discharge care, affect 30-day hospital readmission rates over a 90-day implementation period? The purpose of this DNP …

Implementing Routine Trauma Screening Using The Ace Questionnaire And Pcl-5, Esther Amune

Walden Dissertations and Doctoral Studies

This evaluation of a quality improvement initiative addressed inconsistent trauma screening and electronic documentation at an outpatient site. The baseline trauma-screening completion rate was 60%, below the organization's 80% target. The gap was relevant to nursing because nurses support screening, documentation, referral, coordination, and follow-up. The practice-focused question addressed whether the Adverse Childhood Experiences (ACE) Questionnaire and the Posttraumatic Stress Disorder Checklist for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or PCL-5, would improve documented screening completion and trauma-informed treatment planning over 10 weeks. The purpose was to incorporate both tools into care and …

Staff Education To Improve Skills In Detecting And Addressing Medication Nonadherence Among The Psychiatric Nursing Staff, Uchenna Owunna

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project focused on addressing the knowledge gap of medication nonadherence patterns by the psychiatric nurses in outpatient settings. Nonadherence to psychiatric medications is a major health issue that leads to disruptions of care and symptom relapse, hospitalization, and suboptimal treatment outcomes as well as high healthcare costs. Thus, improving the capacity of the psychiatric nurses to enhance medication adherence through staff education is essential. The purpose of this DNP project was to determine if a comprehensive medication adherence education program would increase psychiatric nurses’ knowledge and skills in assessing …

Implementation Of A Standardized Columbia-Suicide Severity Rating Scale Screening Process In An Outpatient Psychiatric Practice, Dela Mensah Frimpong

Walden Dissertations and Doctoral Studies

This doctoral project was an organizational change initiative designed to implement a standardized suicide risk screening process in an outpatient psychiatric practice. The identified practice problem was inconsistent staff use and documentation of suicide risk screening, which could result in missed warning signs, delayed provider notification, incomplete documentation, and inconsistent follow-up care. Suicide risk identification is an essential nursing responsibility and a key component of patient safety (The Joint Commission, 2024; Zero Suicide, n.d.). The practice-focused question examined whether staff education and implementation of a standardized Columbia-Suicide Severity Rating Scale (C-SSRS) workflow would improve staff compliance, documentation completion, and knowledge …

Staff Education On Medication Nonadherence In Primary Care Clinic, Priscillia Adaugo Obasi

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a staff education initiative designed to address the practice problem of a lack of evidence-based approaches to patient education on medication compliance in a primary care clinic. A literature search was conducted using PubMed, CINAHL, MEDLINE, and the Cochrane Library search engines/databases, revealing nine studies that supported the premise that patient education can promote medication compliance. A practice-focused question underpinning this project was: Will staff education on evidence-based methods for educating patients about the importance of medication adherence result in increased staff knowledge? Baseline staff knowledge and educational needs were obtained using …

Improving Pcu Nurses’ Knowledge Of Evidence-Based Mindfulness Techniques Through Targeted Education, Dairia Moore Mohammed

Walden Dissertations and Doctoral Studies

The progressive care unit (PCU) is a high-acuity setting in which nurses manage patients with complex health conditions, respond to rapid changes in clinical status, and navigate ongoing physical and emotional demands. The practice problem that I addressed was, presently, stress-management support is typically informal, optional, and reactive rather than systematic, evidence-based, and preventive. The purpose of this project was to implement and evaluate a structured educational intervention designed to increase nurses’ knowledge of evidence-based mindfulness breathing techniques that could be integrated into the daily PCU workflow. The practice-focused question was: In PCU nurses in an acute care setting, how …

Reducing Urinary Tract Infections In Long-Term Care Residents, Felicity Antwi

Walden Dissertations and Doctoral Studies

This quality improvement (QI) project addressed delays in diagnosing urinary tract infections (UTIs) at a skilled nursing facility (SNF), where reliance on urine culture testing and patient monitoring resulted in an average diagnostic period of 72 hours. A high UTI incidence and UTI-involved hospitalization rate are both nurse-sensitive indicators that are important to address in the nursing practice context because they portend negatively for nursing quality and safety. This quality improvement (QI) project addressed the practice-focused question: among long term care (LTC) residents with suspected UTIs in a nursing home (NH), how does reducing the diagnostic period from 72 hours …

Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood

Walden Dissertations and Doctoral Studies

The healthy immigrant effect (HIE) is an observed phenomenon in which immigrants exhibit better health outcomes than native-born residents, though relatively few studies have examined its role in chronic diseases in the United States. The purpose of this quantitative cross-sectional study was to assess the associations between immigration status, age, sex, race/ethnicity, median household income, and geographic location and lung cancer diagnosis in first-generation immigrant adults aged 18 or older. The subsequent health trajectory model provided the theoretical framework for the study. Data were obtained from the SEER*Stat Database 1975-2022 (N = 1,993). Binomial regression analysis showed that immigrants were …

Implementation Of An Electronic Gad-7 Screening Tool To Improve Anxiety Screening Completion And Documentation, Obiageli L. Ukatu

Walden Dissertations and Doctoral Studies

Quality Improvement Initiative Implementation of an Electronic GAD-7 Screening Tool to Improve Anxiety Screening Completion and Documentation

Implementation Of A Fall-Prevention Clinical Practice Guideline In A Neurological Rehabilitation Center, Ron L. Adolph

Walden Dissertations and Doctoral Studies

This executive summary presents the final plan for implementation of an evidence-based fall-prevention clinical practice guideline on an open neurological rehabilitation unit. It does not propose a new device, a new electronic platform, or a separate education-only initiative. The practice change is the implementation and evaluation of a structured interdisciplinary clinical practice guideline designed to reduce inpatient falls and improve the reliability of daily prevention practices. The unit reports a baseline fall rate of 6.3 falls per 1,000 patient days. Thirty-five staff members from nursing, therapy, and support roles completed the survey, and 57% reported that patients had experienced falls …