Medicine and Health Sciences Commons^™

Evalutaing The Effectiveness Of A Two-Year Nurse Residency Program On Reducing Nursing Turnover In The One To Three Years Tenure, Nancy J. Plum

Doctor of Nursing Practice (DNP) Manuscripts

Background: First-year turnover for new registered nurses continues to take the lead in all tenured categories, accounting for 59% of turnover, carrying with it a financial impact averaging $88,000 per staff nurse lost. A synthesis of the literature finds the research to be ambiguous and anecdotal, with a narrow focus on understanding the causes of turnover, while an underwhelming amount of rigorous research has been conducted on identifying effective solutions. Solutions to mitigate nursing turnover will require an innovative approach.

Purpose: This program evaluation aimed to examine the impact of a two-year nurse residency program (NRP) on registered nurse turnover …

Enhancing Nurses’ Joy And Meaningful Work In A Military Treatment Facility: A Quality Improvement Project, Ann M. Uetz

Doctor of Nursing Practice (DNP) Manuscripts

Background: Prior to the pandemic, there was growing concern regarding nurse burnout and retention – concern which still exists today in healthcare organizations. Purpose and happiness in work ensures staff engagement, positive patient outcomes, improves nurses’ well-being, and decreases burnout. The Institute of Healthcare Improvement’s (IHI) Quadruple Aim emphasizes improving the work life and well-being of healthcare teams. IHI’s white paper, Joy in Work, outlines nine components to guide interventions for enhancing joy and meaningful work. Purpose: This project’s purpose is to determine the impact of implementation of the Joy in Work’s framework on registered nurses and nursing leadership …

The Implementation Of A Pilot Program On Puberty And Menstruation Education For Adolescent Females And Youth Development Specialists For A Gender-Specific Community Organization: A Quality Improvement Project, Cassandra Tavares

Doctor of Nursing Practice (DNP) Manuscripts

Background & Significance: Adolescent girls in the United States (U.S.) often lack adequate education and support regarding puberty and menstruation, despite the importance of this knowledge for healthy development (Schmitt et al., 2022). Only 21% of school systems serving ages 8–12 provide puberty education, and many educators feel unprepared to teach it (Schmitt et al., 2022). Purpose: This quality improvement project aimed to equip youth development specialists (YDS) at a community organization with a structured curriculum and educational tools to confidently educate adolescent females (ages 8–13) on the physical, emotional, and social aspects of puberty and menstruation. Intervention: A four-day …

Staff Education To Reduce Medication Errors In An Outpatient Mental Health Clinic, Oluwatoyin Rotimi

Walden Dissertations and Doctoral Studies

Summary Medication errors are a common concern within the healthcare industry, increasing healthcare costs and harming patients. The Doctor of Nursing Practice (DNP) project focuses on a staff education initiative to improve knowledge regarding using the Bar Code Management System (BCMS) to reduce medication errors in an outpatient mental health clinic. The identified gap in practice was the lack of knowledge on using the BCMS in outpatient mental health. The guiding practice-focused question was “Does educating the intake nurses on the barcode management systems improve knowledge, as evidenced by pre- and post-surveys?” The Analysis, Design, Development, Implementation, and Evaluation (ADDIE) …

Evaluating Dosimetric Outcomes In A Prostate Rapid Plan Model: A Comparison Of Prostate Treatment Plans With And Without Standardized Planning Structures, Erica Wartman

Masters Projects

Abstract

Knowledge-based planning (KBP) using RapidPlan (RP) has demonstrated the ability to produce high quality radiation therapy treatment plans while reducing time. This study evaluated whether the inclusion of department specific standardized planning structures, including rings and other optimization tools, improves plan quality when using a prostate and lymph node RP model, or if the model alone is sufficient to provide a quality plan without the use of these additional planning structures.

Ten previously treated Prostate+LN patients were replanned using the departmental RP model in Varian Eclipse treatment planning system.1 For each patient, two plans were created, one with standardized …

The Lived Experience Of In-Home Social Distancing And Other Preventative Measures Among Covid-19-Positive Individuals And Other Household Members, Jimmette Naytwain Brooks

Walden Dissertations and Doctoral Studies

The novel Coronavirus Disease 2019 (COVID-19), first detected in Wuhan, China, is caused by a new virus strain: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On March 11, 2020, COVID-19 was classified as “the second pandemic of the 21st century” by the World Health Organization. To better control the spread of the virus, governments and communities adopted several established public health protocols to quell the spread of the disease and decrease the resulting morbidity and mortality. Specific measures included masking, hand hygiene, social distancing and disinfection. Though these are proven measures, not much was known about adherence in the home …

Exploring The Self-Efficacy And Experiences Of Caregivers Using Thickened Liquids To Manage Pediatric Dysphagia, Jaimee E. Conmy

Electronic Theses and Dissertations

Pediatric dysphagia affects 1 in 37 typically developing children under five, with increased prevalence in at-risk populations. Thickened liquids are often used as an intervention despite limited evidence supporting their effectiveness in the pediatric population. Caregivers play a critical role in managing their child’s dysphagia, yet their experiences, self-efficacy, and challenges with thickened liquids remain underexplored. This mixed-methods study surveyed 57 caregivers of children on thickened liquid diets, to assess their self-efficacy, education, perceptions of effectiveness, and overall impact on their quality of life. Findings highlight gaps in caregiver training, concerns about preparation, and benefits and/or challenges experienced by caregivers. …

Quality Improvement Project Impact Of Impostor Phenomenon On Medical Personnel, Elizabeth L'Heureux

Doctor of Nursing Practice Projects

The DNP project examined medical healthcare personnel who displayed an impostor phenomenon (IP), as reflected in the Perceived Stress Scale (PSS-10) surveys, identifying a lack of structured support for reducing stress. The aim of the quality improvement project (QI) is to evaluate the impact of a four-week structured mentorship and resilience training intervention on perceived stress levels among medical healthcare personnel experiencing symptoms of the impostor phenomenon. The QI project utilized the Cognitive-Affective framework to shape what needed to change, the origins of IP stress, while Lewin’s Change Theory guided how to implement and sustain those changes. A quasi-experimental study …

The Effects Of A Breastfeeding Educational Program On Nurses’ Self-Efficacy And Knowledge, Amanda Quinn

Doctor of Nursing Practice Projects

Breastfeeding, a cornerstone of maternal and infant health, faces barriers due to inadequate healthcare provider education, contributing to low exclusive breastfeeding rates. The purpose of this quality improvement project was to evaluate the impact of a four-week educational program on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. This project evaluated a four-week educational program’s effect on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. Using a quasi-experimental pre-post design, nine licensed/certified staff (medical assistants, licensed practical nurses, registered nurses, advanced practice registered nurses) …

Quality Improvement Project Evaluating The Impact Of A Structured Training Program On Cultural Competency Among Mental Health Providers In A Local Outpatient Clinic, Adedamola Adefioye

Doctor of Nursing Practice Projects

Culturally responsive care is critical in addressing mental health disparities, but many mental health providers express feeling unprepared to engage with culturally diverse patients. Low cultural competence is associated with communication failures, lack of patient trust, and the possibility of poorer treatment outcomes. This quality improvement project evaluated the impact of a structured cultural competency training program at an outpatient behavioral health clinic. A quasi-experimental, one-group pre-test/post-test design was used with the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals - Revised (IAPCC-R). Eight licensed mental health providers participated in four weekly one-hour interactive training sessions using …

Staff Education Project Building Proficiency In Debriefing And Empowering Healthcare Professionals With Confidence And Knowledge, Kristie Lynn Van Waus

Walden Dissertations and Doctoral Studies

Debriefing is a critical reflective practice in healthcare that facilitates team learning, promotes psychological safety, and supports quality improvement following clinical events. Despite its recognized value, healthcare professionals report limited training and a lack of confidence in participating in debriefing. I conducted this staff education project to increase staff knowledge and confidence related to effective debriefing practices by delivering targeted in-person education and measuring outcomes using a pre- and post-intervention knowledge and confidence assessment. The education focused on the essential elements of effective debriefing and use of a standardized data collection form. Participants completed a preintervention assessment measuring their knowledge …

Improving Effective Assistant Nurse Manager Communication In Obstetrics, Julie Marie Glover

Master's Projects and Capstones

Abstract

Problem: This quality improvement project addresses inconsistent leadership communication among Assistant Nurse Managers (ANMs) in the Obstetrics (OB) department of a hospital in Northern California. ANM and staff concerns around shift handoff, huddles, and leadership responsiveness have created confusion and hindered team coordination. The project aims to improve communication effectiveness scores among OB ANMs from 50% to 75% by July 11, 2025.

Context: The project was conducted in the Maternal-Child-Health (MCH) unit of a hospital in Northern California, specifically targeting communication practices among OB ANMs. Concerns around communication practices were voiced by both ANM leadership and frontline staff, signaling …

Education Plan On Colonoscopy Preparation And Communication To Improve Colonoscopy Prep And Ensure Better Outcomes, Maryam Pourjalil

Walden Dissertations and Doctoral Studies

This Doctor of Nursing practice (DNP) staff education project introduced a formalized staff education program to refine colonoscopy preparation quality at a community gastroenterology clinic. Suboptimal bowel preparation in 20%–30% of colonoscopies resulted in missed lesions, higher costs, and decreased satisfaction of the provided quality of care, which highlighted the need for enhanced staff education in nursing practice. The project question was: Does the education of staff on colonoscopy preparation procedures bridge the existing knowledge gap regarding modern colonoscopy techniques? My goal was to increase staff knowledge regarding standardize prep instructions. The project was designed using best practice evidence and …

Quality Improvement Project Implementing Comprehensive Foot Exams In Pediatric Patients With Diabetes, Jimmy Penn

Doctor of Nursing Practice Projects

Pediatric patients with diabetes face many of the same long-term complications as adults, including neuropathy. Yet screenings are often overlooked in this population. Research shows that pediatric patients with diabetes experience neuropathy symptoms, yet screening in this population remains underperformed. The purpose of this quality improvement project was to implement a comprehensive foot exam for eligible pediatric patients with diabetes and improve provider adherence through education. The project addressed the question: “Among providers in a pediatric endocrinology clinic, how does implementing education on foot exams, compared to no education, impact provider knowledge and compliance with performing pediatric foot exams over …

Eco-Emotions And Climate Activism In Adolescents, Julianna Sahoo

Master's Projects and Capstones

Background. Youth are especially vulnerable to climate change, both physically and psychologically. Combatting climate change will require a coordinated, global effort. Understanding the motivations and emotions behind climate activism is essential to coordinate efforts to combat climate change.

Methods. This research uses survey data collected from first and second year undergraduates (n=521) at a private, urban university in California in the Fall of 2022. Youth were surveyed on emotions related to climate change, activism, compassion, eco-anxiety, and well-being.

Results. Experiencing positive emotions had a stronger relationship with environmental activism compared to negative emotions.

Conclusion. Results suggest climate change communications should …

Reducing Nulliparous, Term, Singleton, Vertex Cesarean Birth Rate, Roseanna Juarez

Master's Projects and Capstones

Abstract

Problem: Cesarean birth rates for nulliparous, term, singleton, vertex (NTSV) pregnancies in the United States continue to exceed the Healthy People 2030 goal of 23.6%, resulting in preventable maternal and neonatal complications and higher healthcare costs.

Context: This quality improvement (QI) initiative was conducted in a high-acuity labor and delivery unit in California’s Central Valley, an area characterized by maternal health disparities, high rates of comorbidities, and limited access to prenatal care. The goal was to reduce the NTSV cesarean rate to 18.0% by July 31, 2025.

Interventions: Guided by Kotter’s 8-Step Change Theory and the Plan-Do-Study-Act (PDSA) framework, …

Mental Health And Substance Use Interventions Within Muslim Community Spaces: A Community Based-Participatory Research Proposal, Halah Mansour Alayleh

Master's Projects and Capstones

Background. Muslim Americans face significant mental health and substance use challenges compounded by Islamophobic discrimination, cultural stigma, and barriers to accessing culturally competent services. They also significantly underuse professional mental health services. Purpose. This study aims to collaborate with Muslim communities within the San Francisco Bay Area to develop a replicable intervention framework for addressing mental health and substance use stigma within mosques and other Muslim community spaces. Methods. The proposal uses a community-based participatory research (CBPR) methodology while integrating the theory of planned behavior (TPB) and stigma theory in the framework. This proposal outlines the four phases of intervention …

A Comprehensive Evidence-Based Educational Initiative For Improving Hand Hygiene, Lyanna L. Chan

Master's Projects and Capstones

Abstract

Problem: Healthcare-associated infections (HAIs) are a persistent concern in assisted living facilities, often resulting from inconsistent hand hygiene practices. Although national guidelines exist, adherence remains suboptimal, especially where staff training and compliance monitoring are limited.

Context: This project took place in a 53-bed assisted living facility without a formal system to track or reinforce hand hygiene. The aim was to improve staff knowledge and promote infection prevention through education.

Interventions: A Clinical Nurse Leader (CNL) led an evidence-based hand hygiene education program. The intervention included interactive training, visual reminders, personal sanitizers, and leadership support during clinical huddles.

Measures: Pre- …

Enhancing Adherence To Oxytocin Administration Guidelines To Reduce Postpartum Hemorrhage Rates In A Labor And Delivery Unit, Maya Denny

Master's Projects and Capstones

Abstract

Background: Postpartum hemorrhage (PPH) remains a critical challenge in maternal care. It shows a 13% PPH incidence rate in a high-risk labor and delivery unit in a northern California medical center, exceeding the national benchmark of 5%–10% based on 2021 ACOG data from 150 patient records.

Problem: There is inconsistent adherence to oxytocin administration guidelines, with only 60% of 100 audited charts documenting fetal and uterine activity, contributing to the elevated rate. The team is looking for a target rate of 90%.

Intervention: This involves implementing a checklist, providing training for 25 clinicians, and conducting two 30-minute simulation scenarios …

Sociodemographic, Neighborhood-Level, And Health-Related Factors Associated With Progression To Bariatric Surgery: A Retrospective Chart Review., Angela Godwin

Electronic Theses and Dissertations

Background: Bariatric surgery is the most effective treatment for patients with Class 3 obesity. However, of individuals who start the bariatric surgical process, only about half undergo surgery. Factors associated with completion, including race, have been described; however, consistent evidence on obstacles remains to be identified.

Objectives: To explore variables based on the Social Ecological Model (SEM) that may be related to bariatric surgery completion.

Setting: A large, private hospital with a Bariatric Center of Excellence in New York City

Methods: This retrospective chart review utilized data from adults who established an initial bariatric surgery visit from April 1, 2012, …

Describing Latent Tuberculosis Infection And Treatment Completion In Virginia: A Social Determinants Of Health Approach, Amber N. Harmon

Electronic Theses and Dissertations

While the treatment of latent tuberculosis infection is a key strategy in tuberculosis elimination nationally and globally, there is a limited understanding of the general prevalence of latent tuberculosis as well as factors related to successful treatment. This dissertation describes the known landscape of latent tuberculosis in Virginia and explores possible factors related to latent tuberculosis infection treatment through three manuscripts. The first manuscript, Chapter 1, outlines the overall proposal for this dissertation research in the style of a National Institute of Health grant proposal. The second manuscript, Chapter 2, describes the current understanding of the factors related to latent …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

The Application Of Macrophage-Targeted, Anti-Inflammatory Celecoxib Nanoemulgel For Nerve Regeneration In Peripheral Nerve Injury, Lu Liu

Electronic Theses and Dissertations

Peripheral nerve injury (PNI) refers to damage to the nerve located outside the brain and spinal cord. PNI is commonly caused by a physical accident (trauma) or medical operation^{1, 2}. The impact on the quality of life of PNI patients is directly correlated to neuropathic pain, resultant depression, and increased stress². Even after recovering from the PNI, patients still experience phantom pain and lose the ability to work due to the loss of tactile sensory or motor function^2-4. However, unlike damage to the central nervous system (CNS), peripheral nerves can regenerate because macrophages clean …

Implementation Of Medication Administration Education To Increase Medication Technician Knowledge And Confidence, Nicole C. Yan

Master's Projects and Capstones

Problem: Medication technicians have minimal formal training and education in medication administration. Insufficient knowledge and a lack of confidence present safety concerns, such as medication errors, which decrease the quality of patient care.

Context: The setting is an assisted living facility in the San Francisco Peninsula that provides around-the-clock patient care, promoting independence in a safe and home-like environment for 53 patients.

Interventions: The proposed intervention involves implementing a quality improvement (QI) project to educate medication technicians on medication administration safety. The educational sessions, completed in two in-person sessions, include a PowerPoint lecture, interactive case studies, and group discussion.

Measures: …

Empowering Medical-Surgical Nurses To Conquer Burnout: Building Resilience And Wellness, Catherine P. Morante

Master's Projects and Capstones

Problem: In the healthcare industry, nurse burnout is a well-documented issue that affects the well-being of both healthcare professionals and their patients. Burnout manifests as intense exhaustion, depersonalization, and diminished personal accomplishment (Okoniewski & Verni, 2024).

Context: Burnout affects patient outcomes and drives up costs (Dall’Ora et al., 2020). When nurses are overwhelmed, attendance is affected (Unpublished confidential document; 2024). Resilient nurses are essential to a healthy, reliable workforce (Unjai et al., 2024).

Interventions: From May to July 2025, a 12-week initiative was launched to reduce the effects of nurse burnout in the workplace. Evidence-based interventions were implemented, incorporating educational …

Illuminating Leadership Excellence: An Evidence-Based Qi Intervention Reigniting Nurse Leaders From Burnout To Brilliance Using Caring Science And Reflective Practice, Matthew S. Elliott

Master's Projects and Capstones

Abstract

Problem: A 2024 assessment at a 250‑bed Northern California medical center revealed that 76% of 16 inpatient nurse leaders met "high‑burnout" criteria on the Maslach Burnout Inventory, and leader turnover had climbed to 25%, more than triple national benchmarks, threatening patient care quality, financial stability, and alignment with Magnet® and employee engagement goals.

Context: Root causes included pandemic‑era promotions without development support, a task‑oriented leadership culture, and eroding psychological safety (Press Ganey engagement ≈ 30%). An integrative logic model positioned Watson's Caring Science as the theoretical base, Schön's Reflective Model for adaptive learning, and the Prosci ADKAR change framework …

Enhancing Client Intake Efficiency In The Removal Defense Program: A Nursing-Led Quality Improvement Initiative, Johnny Linares, Julia Tran Ngo, Daniel Orea, Atheana Yadira Lopez

Master's Projects and Capstones

This quality improvement project focuses on optimizing the intake process for the Removal Defense Program at a nonprofit immigration legal office serving asylum-seeking clients. The existing intake relied on unstructured, phone-call-based intake interviews that gathered incomplete information, leading to inconsistent documentation, reduced efficiency, and significant client processing delays. A structured, multilingual, and multiplatform new-client admission protocol coupled with the implementation of a client-facing resource guide for waitlist clients were co-developed and implemented using the Lippitt Change Theory framework. Utilizing a mixed methods approach, the study involved staff interviews and observational assessments with staff members from the program. Baseline intake process …

Empowering Occupational Therapists: Navigating Cancer Care Through The Lens Of Moho​, Luis G. Lares

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Cultivating Inclusion: A Multicultural Sensory Garden For Pediatric Occupational Therapy​, Carolyne Teixeira

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Defining, Educating, And Inspiring Young Diverse Students About The Career Of Ot, Matthew Pinckney

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.