Medicine and Health Sciences Commons^™

Quality Improvement Project: Faculty Education On Clinical Evaluation Tool Utilization For Outcome-Based Assessment And Readiness In Clinical Competency Evaluation, Catherine Odom

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement initiative addressed the lack of consistency and subjectivity in clinical evaluations of nursing faculty at a community college in the southern United States. The intervention was a structured faculty development program spanning eight weeks, focusing on Objective Structured Clinical Examinations (OSCEs) and performance rubrics. The project was guided by the IOWA Model of Evidence-Based Practice and the Kotter Change Management Framework, aiming to boost faculty confidence and inter-rater reliability in clinical assessment. The PICOT question was whether a structured educational intervention would enhance self-reported faculty confidence in clinical assessments relative to no …

Quality Improvement Project Improving Self-Efficacy Among Urgent Care Staff Through Medication Reconciliation Education, Jana M. Combs

Doctor of Nursing Practice Projects

Medication errors and adverse drug reactions (ADR) are a significant source of preventable harm in healthcare, and failure to complete proper medication reconciliation is a contributing factor. Despite multiple interventions aimed at addressing this issue, no standardized plan has been implemented universally. Outpatient urgent care sites pose as high-risk environments for failed medication reconciliations due to the nature of the setting, but staff are in prime positions to adjust this culture. This project aimed to enhance staff self-efficacy in medication reconciliation over four weeks through an evidence-based educational program, with the goal of improving patient safety and outcomes. Using a …

Quality Improvement Project Data At Risk: The Implications Of Inconsistent Nursing Documentation On Patient Care Interventions, Amber Jones

Doctor of Nursing Practice Projects

Accurate nursing documentation plays a vital role in ensuring high-quality patient care, yet inconsistencies remain a common challenge, particularly with preventive screenings like pediatric tobacco use. Research shows that when documentation is incomplete or incorrect, opportunities to identify and intervene with at-risk adolescents are often missed. This quality improvement project was developed to address a specific gap in documentation practices at a community health clinic, where staff often failed to consistently complete the pediatric tobacco screening tool. The goal of the project was to determine whether evidence-based education, combined with chart audits and feedback, could improve the consistency in which …

Quality Improvement Project Improving Advanced Practice Registered Nurse Self-Efficacy And Retention Through A Structured Mentorship Program, James Caleb Kent

Doctor of Nursing Practice Projects

High turnover among Advanced Practice Registered Nurses (APRNs) creates significant challenges for healthcare delivery, continuity of care, and organizational costs. Despite convincing evidence supporting the use of mentorship programs to improve job satisfaction and retention, structured mentor education remains underutilized in many outpatient settings. This quality improvement project assessed the impact of a structured mentor education program on APRN self-efficacy related to mentoring competence. A single-group, pre-post design was implemented in one primary care department. Six APRNs completed an evidence-based mentor education module. Self-efficacy was measured using the Mentor Competence Assessment (MCA) survey administered immediately before and after education. Paired …

A Quality Improvement Project Cultural Competency: A Project For Improving Culturally Competent Care Among Mental Health Providers, Lanre Olanrewaju

Doctor of Nursing Practice Projects

Cultural competence, knowledge, and awareness are essential for improving mental healthcare outcomes in diverse populations. Despite the need, the absence of structured cultural competence training contributes to reduced quality of care and health disparities. The purpose of this quality improvement project is to improve cultural awareness and knowledge among mental health providers at an outpatient clinic by implementing structured staff training. A needs assessment identified gaps in cultural competence knowledge, inconsistent practices, and limited provider confidence in addressing diverse patient needs. In the methodology, the model used to answer the PICOT question is Purnell’s Model, guided by a structured process …

Childhood Vaccination In Mozambique Pre- And Post-Covid-19 Pandemic, Remy Mwamba

Walden Dissertations and Doctoral Studies

In 2019, infectious diseases and other conditions claimed the lives of over 5 million children under 5. Global immunization coverage remains below prepandemic levels, leaving behind over 14 million zero-dose children in 2022, of whom 84% lived in low- and middle-income countries. This quantitative cross-sectional study aimed to examine, using two consecutive Demographic and Health Surveys, whether the most significant household characteristics and health service utilization risk factors associated with nonvaccination before the COVID-19 pandemic still hold postpandemic in Mozambique. Andersen's behavioral model of healthcare service utilization was the foundation for this investigation. The sample included N=2034 children aged 12-35 …

Evaluating Coplanar And Noncoplanar Treatment Plans For The Varian Halcyon And Varian Truebeam For Intact Prostate Patients., Ashley Coppage

Masters Projects

Prostate cancer is among the most treated malignancies with radiation therapy, where precise dose delivery is critical for tumor control and minimizing toxicity. VMAT is widely adopted due to its efficiency and conformity; however, the choice between coplanar and non-coplanar beam arrangements remains an area of ongoing investigation, especially with newer platforms like Halcyon and TrueBeam. This retrospective dosimetric study compares coplanar and non-coplanar volumetric modulated arc therapy (VMAT) treatment plans for intact prostate cancer patients using the Varian Halcyon and Varian TrueBeam systems. Plans were created using a standardized protocol within Eclipse v16.1, with all Halcyon plans employing coplanar …

Non-Pharmacological Interventions For Attention Deficit Hyperactive Disorders And Anxiety, Alichia Lashawn Pecks

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project used a quality improvement approach to address the co-prescription of stimulants and benzodiazepines in patients with attention deficit hyperactivity disorder (ADHD) and anxiety in outpatient mental health settings. The project explored whether implementing a structured non-pharmacological staff education program for mental health staff could improve knowledge of safe, evidence-based treatment alternatives. The purpose of this staff education project was to improve provider knowledge of evidence-based, non-pharmacological treatment alternatives. To address this issue, a structured non-pharmacological staff education program was implemented to improve provider knowledge of safer, evidence-based treatment alternatives. Four participants completed pre- …

Assessing And Improving Provider Knowledge And Comfort With Palliative Care Consultations: A Quality Improvement Project, Summer R. Hess

Doctor of Nursing Practice Projects

Palliative care remains significantly underutilized in the management of heart failure, despite national guidelines supporting its early integration. This underuse limits opportunities for person-centered care in cardiology settings. The purpose of this quality improvement project was to improve provider knowledge and comfort in implementing palliative care consultations. The problem addressed was the low consultation rates for advanced heart failure patients, largely driven by provider misconceptions and a lack of formal training. A quasi-experimental design was initiated by using a brief, evidence-based educational article. Sixteen advanced practice providers at a high-volume cardiology clinic completed pre- and post-intervention surveys using the End-of-Life …

Quality Improvement Project Evaluation Of The Effectiveness Of The Institute For Healthcare Improvement’S Joy In Work Framework On Burnout Experienced By Dialysis Staff, Bernice Jones

Doctor of Nursing Practice Projects

Burnout continues to pose a pervasive and escalating challenge in healthcare, with its severity further amplified in the aftermath of the COVID-19 pandemic. Dialysis professionals are especially vulnerable, facing elevated patient volumes, extended work hours, and frequent encounters with complex clinical needs. These ongoing stressors highlight the critical importance of this quality improvement (QI) project, as there exists an urgent need for evidence-based strategies to alleviate burnout among dialysis professionals. This QI project aimed to enhance joy in the dialysis work setting and reduce burnout experienced by dialysis staff through the implementation of the Institute for Healthcare Improvement’s (IHI) Joy …

Development Of Policy Related To Test Anxiety In High-Stakes Environment, Jancy J. Sabu

Doctor of Nursing Practice Projects

Many nursing students experience test anxiety (TA) due to the highly stressful learning environment and the high-stakes nature of nursing exams. A community college in Texas has experienced an increase in student attrition from 2018 to 2022, primarily due to course failures, which are linked to TA. Expressive writing (EW) is a proven intervention that allows students to write about their anxieties and fears related to exams, helping them to regulate their emotions and manage TA. This project aimed to develop a policy that implements EW as an intervention and incorporates it into the nursing syllabus. Using the Centers for …

The Impact Of The Implementation Of A Code Lavender Stress Management Program On Post-Surgical Critical Care Nurses’ Stress, Solange Ngoundjou

Student Scholarly Projects

Practice Problem: Post-surgical critical care nurses face a variety of stressful events when providing patient care. And there is a strong relationship between job stress, provision of patient care, patient satisfaction, and the overall well-being of the organization.

PICOT Question: For post-surgical critical nurses who are part of a stressful event (P), do evidence-based stress management strategies (I) compared to the current practice (C), reduce stress (O) within 8 weeks (T)?

Evidence: The evidence that guided this project change is based on John Hopkins’ nursing evidence-based practice model, and Lewin’s Change theory.

Intervention: The Code Lavender …

Socioecological Factors And Age Of Diagnosis For Autism Spectrum Disorder Among U.S. Children, Richline Wilson

Walden Dissertations and Doctoral Studies

As autism spectrum disorder (autism/ASD) diagnoses rise, understanding the influence of socioecological factors on the age of diagnosis among children in the United States is critical for timely intervention and improved quality of life. The purpose of this study was to examine how socioecological factors influence the age at which children are diagnosed with autism/ASD. The quantitative causal-comparative design, which was informed by Bronfenbrenner’s socioecological model, involved analysis of secondary data from the 2021 National Survey of Children’s Health (N=1416). Ordinal logistic regression analysis revealed that race and ethnicity moderated the relationship between socioeconomic status (caregiver educational and employment status …

Staff Education To Enhance Nonmedical Staff Competency In Withdrawal Management, Katherine Hedrick

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a significant gap in staff training at a behavioral health residential treatment facility. Nonmedical staff, including substance abuse counselors, lacked formal education in recognizing, assessing, and escalating symptoms of substance withdrawal. This lack of competency posed a risk to patient safety, regulatory compliance, and quality of care. The goal of the project was to evaluate the impact of a structured, simulation-based training program on nonmedical staff’s knowledge and confidence in using validated withdrawal assessment tools and monitoring vital signs. Six nonmedical staff participated in the training, which incorporated lecture, hands-on simulation, and …

Evaluating Parotid Gland Dose Between Electronic Tissue Compensation And Field In Field Treatment Techniques For Parotid Sparing In Whole-Brain Radiotherapy, Joesph E. Bodgonas

Masters Projects

Purpose:

The parotid glands are essential to salivary function and patient quality of life, yet they are not routinely prioritized as organs at risk (OARs) during whole-brain radiotherapy (WBRT). With growing recognition of long-term side effects like xerostomia in patients with prolonged survival after WBRT, parotid-sparing techniques warrant investigation. This study compares radiation dose to the parotid glands using three different 3D conformal WBRT planning approaches: field-in-field (FiF) with blocking, electronic tissue compensation (eCOMP) without blocking, and eCOMP with blocking.

Methods and Materials:

A retrospective study was conducted on 20 patients previously treated with 3D conformal WBRT. Original eCOMP plans …

A Comparative Study Of Vmat Beam Arrangements In Large Field Nodal Prostate Treatment Plans, Laura R. Black

Masters Projects

Treatment of extensive prostate and pelvic lymph node volumes for prostate cancer patients provide unique challenges related to limitations in multileaf collimator (MLC) design in many modern linear accelerators. A strategy to overcome this challenge is by restricting the field size, improving modulation as well as using overlapping arcs to ensure complete coverage of the target. Using too few arcs can result in suboptimal target coverage, while too many arcs can lead to prolonged time on the table, increasing the risk of patient movement and potential side effects that may compromise treatment accuracy. This study aims to evaluate the optimal …

Improving Icu Decolonization Compliance Among Nursing Staff, Sarah J. Moore

Student Scholarly Projects

Practice Problem: Hospital acquired infections (HAIs) burden patients and health care organizations by influencing extended hospital stays, increasing mortality risk, and increasing healthcare spending.

PICOT: The Doctor of Nursing Practice (DNP) Scholarly Project was guided by the PICOT question: In ICU nursing staff (P), how does the implementation of a standardized process with visual reminders and checklists (I) compared to no reminders or checklists (C) impact compliance with the decolonization protocol for HAI reduction (O) over four weeks?

Evidence: A review of evidence-based literature demonstrated efficacy in the reduction of HAIs through once daily bathing with 2% chlorhexidine gluconate (CHG) …

The Development Of A Remediation Policy For High-Stakes Standardized Tests, Abigail R. Brundige

Doctor of Nursing Practice Projects

Standardized testing serves as a measure of academic progress and readiness for licensure in nursing programs. Gaps in standardized testing performance emphasize the need for educational support. The problem identified for this Doctor of Nursing Practice (DNP) policy project is the lack of a formal standardized testing remediation policy within a community college nursing program in rural West Tennessee. The DNP project proposes the development and implementation of a standardized testing remediation policy to identify at-risk students early, provide individualized remediation plans, and improve program retention and licensure pass rates. The DNP project employed a quantitative design to assess the …

Barriers To Participation In Follow-Up Services In Oncology, Casey Wagman

DNP Projects

Background
Psychological distress is often seen in cancer patients due to the physical, emotional, and social burdens of diagnosis and treatment. Patient participation in support services remains low despite the readily available psychosocial resources. The Emotional Well-Being Tool (EWBT), a validated psychological distress screening tool, is often used in a Midwest cancer clinic, yet it was noted that its supportive services were underutilized.

Purpose
This quality improvement project aimed to analyze the perspective of cancer patients on the EWBT, their understanding of its purpose and outcomes, and the perceived barriers to utilizing supportive services.

Methods
It was an exploratory design, …

The Use Of Debriefing To Combat Compassion Fatigue Among Cardiac Intensive Care Nurses, Brittany Johnson

DNP Projects

Background:
Compassion fatigue has physical, emotional, and psychological impacts on nurses working in intensive care units. Debriefing sessions can be used to help reduce compassion fatigue by allowing nurses on a cardiac intensive care unit to discuss their thoughts and feelings after the death of a patient who has had a complex hospital stay or traumatic death.

Aim:
The purpose of this project was to assess the perception of compassion fatigue on work life among Cardiovascular Intensive Care Unit (CVICU) nurses and to evaluate whether debriefing sessions following demanding situations enhance nurses' coping abilities and emotional processing.

Methods:
Nurses working …

Evaluation Of Mrcat As A Surrogate For Traditional Ct Simulation In Proton Prostate Radiotherapy Planning, Karen Weeks

Masters Projects

Purpose:

This study evaluated whether Philips MRCAT-generated synthetic CT (sCT) can serve as a clinically viable substitute for traditional CT (CT) simulation in proton therapy planning for prostate radiotherapy using a double-scatter technique.

Methods:

Ten prostate cancer patients treated with proton therapy between 2024 and 2025 were retrospectively analyzed. Each patient underwent both CT and MRI in the treatment position. MRCAT sCT images were generated using atlas-based and segmentation algorithms. The original proton treatment plan was transferred onto the MRCAT dataset. Dosimetric parameters, target coverage, organ-at-risk (OAR) doses, and Hounsfield Unit (HU) values were compared. The sign(M) test …

Magnet Council Toolkit For Organizations Seeking Magnet Status And Recruitment, Andrew J. Boone

Student Scholarly Projects

Practice Problem: The problem was a lack of a standardized or structured process for the development of Magnet Councils. There is no clear pathway or materials to initiate the process, and one must start by applying to the American Nurses Credentialing Center (ANCC) with little guidance prior to seeking help on the Magnet Journey. PICO Question: The PICO question that guided this DNP Project Toolkit development was as follows: For healthcare organizations pursuing Magnet status (P), how does the development of a structured Magnet Council Toolkit (I) compared to the absence of a formal toolkit (C), contribute to the validation …

Staff Education On Depression Screening In Young Adults, Irene Micere Njeru

Walden Dissertations and Doctoral Studies

Summary This doctoral project was on staff education. The practice problem was a knowledge deficit regarding depression screening by staff nurses at a local acute inpatient psychiatric facility. The practice-focused question was as follows: Will education on depression screening for young adults (18-to-28-year-olds) increase knowledge on the use of evidence-based depression screening tools by nursing staff in an inpatient psychiatric crisis facility? The purpose of the doctoral project was to educate staff nurses at a local acute inpatient psychiatric facility on the PHQ-9 depression screening tool for individuals aged 18 to 28 years. The project included a PowerPoint presentation, a …

Enhancing Communication Among New Nurses Using Scenario-Based Education, Anita Clark Chambers

Walden Dissertations and Doctoral Studies

This staff education project was designed to enhance communication among new nurses with 2 years or less of experience in a Level One trauma center emergency department (ED). The aim of this project initiative was to enhance learners’ communication strategy knowledge and confidence by using scenario-based education via a web-based format. When ineffective communication exchanges occur with healthcare personnel, such as with new nurses, negative patient care outcomes can occur such as sentinel events. Transitional challenges such as lack of prioritization, clinical decision-making skills and low confidence can affect the new nurse’s ability to appropriate effective communication strategies into their …

Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan

Walden Dissertations and Doctoral Studies

Falls are the most common adverse events leading to increased injury, length of hospital stay, and costs among hospitalized patients. I developed a staff education project to address the identified practice problem of increased fall rates on the cardiac floor of the project site. The practice-focused question guiding this Doctor of Nursing Practice (DNP) project was whether a comprehensive staff education program on evidence-based fall prevention strategies could improve the nurses’ knowledge when compared to standard fall prevention practices. The purpose of this DNP project was to provide staff education to increase nurses’ knowledge about the early identification of fall …

Enhancing Novice Nurse Educator Success: A Comprehensive Orientation And Mentorship Program, Emily R. Luther

Doctor of Nursing Practice Projects

Nursing education programs face challenges from faculty shortages, high turnover, and limited onboarding support for new educators. This Doctor of Nursing Practice (DNP) project assessed the effectiveness of a structured orientation and mentorship program aimed at improving competency, job satisfaction, and retention among novice nurse educators within a mid-sized nursing program in the southeastern United States. The project addressed gaps in existing onboarding processes that left new faculty unprepared, which contributed to dissatisfaction and attrition. A mixed-methods pre- and post-intervention design was utilized. Quantitative data were gathered through the Self-Assessment of Nurse Educator Competencies (SANE-C), the Minnesota Satisfaction Questionnaire (MSQ), …

Development Of A Clinical Practice Guideline For Trauma-Informed Care In Interprofessional Health Care Settings, Ngwi Rita Etiendem

Walden Dissertations and Doctoral Studies

Developing a standardized Clinical Practice Guideline for Trauma Informed Care was a central objective of this Doctor of Nursing project. This project followed an evidence-based, collaborative, and structured methodology that prioritized interdisciplinary input, organizational alignment, and rigorous appraisal using the AGREE II instrument.

Staff Education To Same Day Surgery Nurses, Katherine Lutman

Walden Dissertations and Doctoral Studies

The aim of this doctor of nursing practice staff education project was to provide a staff education program to the same day surgery staff at the practicum site on the Enhanced Recovery After Surgery (ERAS) evidence-based approach to surgical care to improve patient outcomes. ERAS includes multiple modalities designed to optimize a patient’s condition before, during, and after surgery. When implemented correctly, ERAS can reduce the need for narcotics, shorten recovery time, and improve surgical outcomes. The practice gap identified was that the only ERAS modality being actively implemented and tracked was nutrition in colorectal surgical patients and that the …

Joint Kinematics And Kinetics During Vertical Jump Landings With Progressively Increasing External Loads, Darcie L. Yount

Dissertations

This study examined sagittal and frontal plane kinematics and kinetics during countermovement jump (CMJ) landings performed with either a traditional barbell (BB) or a hexagonal bar (HEX) across increasing submaximal loads in recreationally active males. Generally, hip and knee flexion angles and joint mean angular velocities decreased as loads increased. Hip extension and knee flexion moments increased as load increased up to 20 kg, at which point these values decreased. Performing the CMJ with the HEX exhibited increased frontal plane stability compared with the BB group. Additionally, the BB group exhibited stiffer landing strategies, with decreased sagittal plane joint angles …

Exploring The Connection Between Emotional Intelligence And Academic Achievement In Senior Nursing Students, Kimberly Smith

Dissertations

The need for nurses is now greater than ever, with a projected shortage of nearly five million nurses by 2030. Several factors exist that hinder the number of practice-ready nurses, causing nursing programs worldwide to explore and re-examine admission practices and increase student retention rates. The American Association of Colleges of Nursing (AACN, 2024) reported that over 100,000 students were denied enrollment in baccalaureate and graduate nursing programs in 2024, indicating that maximizing admission processes is crucial in addressing the current nursing shortage. This emphasizes the need for greater participation to ensure that all students have access to the educational …