Medicine and Health Sciences Commons^™

Perceptions Of Nurse Preceptor Program Structure, Process, And Outcomes, Shinto Thomas

Walden Dissertations and Doctoral Studies

Precepting is crucial in successfully onboarding nurses in healthcare organizations, yet challenges remain in ensuring effective preceptor development. Well-structured preceptor programs contribute to consistent and safe nursing practices, enhance job satisfaction and competency among new nurses, and improve preceptor effectiveness while minimizing turnover. This quality improvement Doctor of Nursing Practice (DNP) project evaluated a structured nurse preceptor program's structure, process, and outcomes, focusing on its impact on clinical and critical thinking skills development through enhanced training and support. A key gap in understanding the program’s effectiveness was the lack of outcome data. This study explored participants’ perceptions of the preceptor …

The Generalized Anxiety Disorder 7-Item (Gad-7) Tool For Anxiety Screening, Nicholas Tindong

Walden Dissertations and Doctoral Studies

The staff education project aimed to address the gap in practice regarding the use of the Generalized Anxiety Disorder 7-item (GAD-7) screening tool at a psychiatric clinic. Approximately 40% of the clinic’s patients exhibited symptoms of generalized anxiety disorder (GAD), yet the nurses did not consistently use validated tools to assess anxiety severity, relying instead on unstructured clinical interviews. This inconsistency has resulted in delayed diagnoses and suboptimal patient care. The project sought to improve nursing staff's knowledge and confidence in using the GAD-7 tool through a structured education program guided by the following practice-focused question: Among nurses at a …

Reducing Disparities In Breastfeeding Among African American Women Through Professional Support, Latonia Feagin

Walden Dissertations and Doctoral Studies

This project involved developing a toolkit and implementing a staff education program to increase provider self-efficacy and knowledge concerning breastfeeding, increase provider understanding of the importance of a toolkit for addressing the gap in breastfeeding among African American women, and increase the intention of providers to use the toolkit by a minimum of 20%. The clinic reported breastfeeding in only 21% of African American patients, attributing this mainly to provider lack of breastfeeding self-efficacy and knowledge. It is essential for providers to deliver evidence-based, culturally sensitive breastfeeding information. This project involved evaluating provider self-efficacy, knowledge, understanding the importance of a …

Allostatic Load And Incident Dementia Among Older Adults In The United States, Mohammed Usman Kabeto

Walden Dissertations and Doctoral Studies

Allostatic load (AL), the cumulative physiological burden of chronic stress, is a significant health problem, and it has been associated with adverse health outcomes, including cognitive functioning. There is a paucity of literature examining associations between AL and incident dementia in the United States. This quantitative study used data from the United States Health and Retirement Study cohort (2016-2020) to examine the association between AL quartile and incident dementia among participants who were aged 56 and older at baseline. Dementia status was determined measuring immediate and delayed recall, serial seven subtraction, and backward count, as well as self-report conditions for …

Staff Education On Medication Nonadherence For Patients With Bipolar Disorder, Julius Chick Abam

Walden Dissertations and Doctoral Studies

Summary From both the literature and the staff observation in this private practice, bipolar disorder (BD) patients who do not comply with medication are at a higher risk of hospitalization and poor quality of life. The purpose of the project was to implement staff training focused on adherence strategies, including motivational interviewing and psychoeducation to improve medication adherence rates among BD patients. The project question was: Does providing an interactive education program using case studies improve staff knowledge and self-confidence? Different studies support the effectiveness of both psychoeducation and motivational interviewing in improving adherence and functionality in BD. An interprofessional …

Residence, Education, Wealth, And Hiv/Aids Prevention Knowledge Among Nigerian Adults, Chinedu Nwaobia Nwaru

Walden Dissertations and Doctoral Studies

HIV has remained the most prevalent and deadliest epidemic affecting humanity. It is pertinent to note that, despite the number of years since the first case was reported in the early 1980s in the United States, and concerted efforts by local, national, and international governmental and nongovernmental agencies at curbing it, the level of knowledge of HIV transmission and the disease prevention, especially among Nigerians, is still not encouraging. Nigeria, the most populous country in Sub-Saharan Africa ranks second globally as the country with the highest number of people living with HIV/AIDS, which is currently estimated at 3 million. In …

Heart Failure Education For Medical Assistants In A Transitions Clinic, Kelly S. Kirk

Walden Dissertations and Doctoral Studies

This capstone project is an educational improvement intervention for medical assistants (MAs), in the transitions clinic for heart failure patients. This capstone was designed to assess baseline heart failure (HF) knowledge of the MA and provide education on HF sign symptoms and urgency of provider notification as well as a postintervention assessment of knowledge. The terminal outcome was to improve the recognition of urgent symptoms that should be reported to providers so that providers can intervene early to prevent a possible exacerbation of heart failure. In order to assess the improvement in education of the MAs before and after the …

The Effectiveness Of Naloxone Staff Education In Reducing Opioid Overdose Mortality Among Young Adults In An Outpatient Behavioral Clinic, Taiwo Oguntade

Walden Dissertations and Doctoral Studies

The Naloxone Staff Education Project was implemented within an outpatient behavioral health practice to address the critical issue of insufficient staff education regarding Naloxone use in opioid overdose responses. Opioid overdoses, particularly among young adults, have become a leading cause of preventable death, with nearly 108,000 deaths recorded in 2022, 76% of which involved opioids. The project aimed to assess the impact of Naloxone education on staff knowledge, competency, and confidence in responding to opioid overdoses among patients aged 18 to 35. Utilizing pre- and post-education assessments, including surveys and interviews, the project evaluated staff readiness to administer Naloxone. Results …

Menstrual Poverty In Egypt: Padding The Way To Period Equity, Sara Hesham Nasr

Theses and Dissertations

With approximately 800 million women menstruating daily worldwide, a significant portion of this demographic experiences barriers to accessing sanitary products. In Egypt, despite having around third of the population in reproductive age and menstruating monthly, an economic turmoil in 2017 opted the government to label menstrual products as luxury items and the prices have increased since then.

The current study aimed to investigate menstrual poverty in Egypt, focusing on the economic and social challenges faced by women during menstruation. Key objectives include assessing the financial challenges related to menstruation, exploring existing policies aimed at alleviating these challenges, and proposing evidence-based …

Utilizing Food As An Art Medium In Eating Disorders Treatment, Keren Blumenthal Yanir

Expressive Therapies Dissertations

This research explored food as an art medium in an innovative art therapy intervention for adults with eating disorders (EDs) and what this nontraditional art material can evoke. Several interventions (e.g., food exposure, cooking, and some family-based therapy) incorporate food in ED treatment, but none use it as an art medium.

Six Israeli adults (one with bulimia nervosa, two with atypical anorexia, and three with anorexia nervosa) individually participated in three meetings, each with a 30-min experiential component and an interview. While wearing a GoPro camera, participants created spontaneous artwork using foods (e.g., vegetables, legumes, pasta, flour, candy). The researcher …

Staff Education On Medication Adherence Teaching For Psychiatric Patients In The Outpatient Setting, Ernestina Akosua Ohene-Agyakwah

Walden Dissertations and Doctoral Studies

Summary The type of doctoral project was staff education. The aim was to address the practice gap of lack of standardized staff education on medication adherence in the outpatient psychiatric care setting. The practice-focused question was "Will staff education on medication adherence for psychiatric patients in the outpatient setting result in an increase in staff knowledge?" To provide staff with the information and abilities they needed to consistently deliver patient education that supported evidence, the project created, carried out, and assessed a structured staff education program. Knowledge changes among the 10 participants were evaluated and measured using the mean difference …

Staff Education Program To Reduce Burnout Using Mindfulness Techniques In A Psychiatric Outpatient Clinic, Miriam Ambe

Walden Dissertations and Doctoral Studies

Burnout is becoming more common among nurses, which has a negative impact on the well-being of nurses, patients, and organizations. The practice problem for this DNP project was the need for more awareness about burnout and associated strategies to address nurse burnout among outpatient nurses in a psychiatric clinic. This DNP project was a staff education program to teach nurses how to identify burnout in themselves while offering them mindfulness techniques to prevent or mitigate burnout. This project’s guiding practice-focused question and framework was, “Will a staff education program on mindfulness techniques to prevent burnout lead to nurses’ identification of …

Increasing Knowledge And Awareness Of Colorectal Cancer Among Nursing Staff, Joelle Woodruff

Walden Dissertations and Doctoral Studies

In the United States, colon cancer rates have dropped since the 1980s as more people are being screened for colorectal cancer. However, despite an increase in screening, rates are expected to increase through 2035. Patients who have a good relationship with their providers are more likely to complete colorectal cancer screening. However, providers rely on support staff to educate patients on the screenings. The local organization has struggled to improve cancer screening rates among its patients. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine whether an education intervention focused on colorectal cancer and screening …

Increasing Colorectal Cancer Screening Completion Rate Among African American Patients By Staff Education, Sloan Mccoy

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States and disproportionately affects the African American population with a higher incidence and mortality rate. This DNP project was implemented in a suburban primary care practice which is part of a large metropolitan health care organization. I implemented staff education about the CRC completion disparity with the African American population and communication strategies found to help improve this. My goal was for the primary care practice staff to increase their knowledge and change their practice behavior with recommending CRC screening to improve CRC screening rates amongst …

Individual And Community-Level Factors Influencing Hiv Testing Among Malawian Women, Miniratu Coker Lawal

Walden Dissertations and Doctoral Studies

The HIV/AIDS epidemic poses a significant public health challenge in Malawi, where women aged 15-49 years experience a higher HIV prevalence (10.8%) compared to men (7.0%). Despite free testing services, 17% of Malawian women have never been tested for HIV, hindering early diagnosis and treatment that could reduce transmission rates. Using Anderson's framework for health service utilization, this study examined how demographic factors (age, marital status, ethnicity, residence) and socioeconomic factors (education, wealth, employment) influence HIV testing among Malawian women aged 15-49 years. Two research questions guided this investigation: 1) the association between demographic factors and HIV testing after controlling …

Staff Education To Increase Substance Use Screening And Treatment For Adolescents In An Outpatient Primary Care Mental Health Facility, Surekha Gorantla

Walden Dissertations and Doctoral Studies

This quality improvement staff education DNP project addressed the practice issue relating to adolescent substance abuse in the project mental health facility. The facility does not have a uniform process for addressing this problem. Follow-up care for adolescents treated in the clinic is a challenge because each provider uses a screening tool of their preference, creating inconsistencies in care and missed care opportunities. Therefore, identifying, reducing, and preventing the negative consequences related to adolescent substance abuse in this clinical setting is vital and needs to be prioritized. I developed and implemented a staff education program using screening, brief intervention, and …

Nurse Experiences Of Caring For Children With Autism Spectrum Disorder In Los Angeles Pediatric Intensive Care Units, Makenna Brown

Walden Dissertations and Doctoral Studies

One in 22 California children is diagnosed with autism spectrum disorder (ASD). In combination with sensory considerations, healthcare costs, and increased healthcare utilization, these children face a lesser quality of care and poorer health outcomes. The literature addresses healthcare needs and experiences from various viewpoints, but does not address the experiences of nurses (RN) caring for children with ASD in the pediatric intensive care unit (ICU). The purpose of this study was to gain an understanding of RN’s challenges, and the helpful strategies utilized in practice. A qualitative, grounded study approach, centered on the patient-and-family centered care conceptual framework, was …

Executive Summary: Educating Staff On The Use Of The Columbia Suicide Severity Rating Scale, Muktar Trawalley

Walden Dissertations and Doctoral Studies

Suicidal ideation is a serious public health concern among individuals, especially in the United States. The Columbia-Suicide severity rating scale (C-SSRS) is the tool used to assess the severity and frequency of suicidal ideations. The gap in practice at this site is that mental health providers lack knowledge of using the C-SSRS. This evidence-based educational project aimed to improve nursing knowledge on using the C-SSRS in a psychiatric mental health facility. A practice-focused question was developed: Among psychiatric nurses in an outpatient mental health facility, does staff education on C-SSRS improve their knowledge of its application over 8 weeks, as …

Staff Education To Improve Phq-9 Depression Screening In Primary Care, Adella Kweyila

Walden Dissertations and Doctoral Studies

The staff education project aimed to address the gap in practice regarding the use of the PHQ-9 depression screening tool in a primary care setting. The providers at the setting demonstrated variations in screening practices leading to potential missed opportunities for early depression identification and treatment. This Doctor of Nursing Practice project explored the question: “What is the effect of implementing a staff education program to improve staff knowledge to effectively implement changes that affect the use of the PHQ-9 screening tool to improve depression identification and treatment of adult patients in a primary care clinic?” This project aimed to …

Staff Education: Antihypertensive Medication Adherence In The Primary Care Clinic, Shannon Leigh Hilling

Walden Dissertations and Doctoral Studies

I completed a staff education project in a primary care clinic focused on increasing staff knowledge of antihypertensive medication adherence. More than 1 in 3 adults in West Virginia (or 41% of the adult population in the state) has hypertension, which is equal to about 602,000 adults. The project question was developed to investigate the extent to which education on hypertensive medications will enhance staff knowledge and their ability to educate patients in the primary care clinic. The staff education project was implemented via PowerPoint, pre-/post education testing, and measurements using an online percentage gain calculator. Findings revealed an overall …

Executive Summary: Clinical Practice Guideline Primary Care Management Of Overweight/Obesity In Adult Women, Getrude Tate Nguatem

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a clinical practice guideline project focused on overweight and obesity management of adult women in primary care. The practice problem identified was the lack of an evidence-based clinical practice guideline to manage overweight/obesity in adult women. It was important to address this problem because overweight and obesity were significant health concerns at this clinical site in the United States and the world. The practice-focused question was the following: “Does the evidence support the development and Appraisal of Guideline for Research and Evaluation (AGREE) II instrument quality scoring of a clinical practice guideline on …

Enhancing Staff Impact On Medication Adherence In A Mental Health Outpatient Clinic, Uzoamaka Lynda Mbadugha

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project addressed the critical issue of medication nonadherence among mental health patients by implementing a staff education program at an outpatient clinic in the Mid-Atlantic region USA. The program focused on enhancing staff knowledge and confidence through training in psychoeducation, motivational interviewing, and multidisciplinary collaboration. Nonadherence often leads to relapse, hospitalization, and poor outcomes, compounded by a lack of structured interventions at the project site. Sixteen clinic staff members participated in biweekly training sessions over a one-month period. Pre- and post-training assessments revealed a 44.79% increase in staff knowledge and a 50% improvement in confidence …

Promoting Consistency In Phq-9 Depression Screening For Young Adults In An Outpatient Mental Health Clinic., Abena V. Prempeh

Walden Dissertations and Doctoral Studies

This project aimed to improve the consistency of PHQ-9 depression screenings for young adults in an outpatient mental health clinic. Through the implementation of standardized protocols and staff training, the goal was to reduce variability in screening outcomes. The evaluation method of the project involved staff interviews, surveys, and comparing pretest and post-test results to measure staff knowledge and confidence improvements. The results showed that there were significant improvements in staff knowledge and confidence. This project highlights the importance of standardized procedures in improving mental health care for young adults.

The Experience Of Genetic Testing Among Latinas With Brca1/2 Mutation, Lisania Milli

Seton Hall University Dissertations and Theses (ETDs)

Healthy women with BRCA1 (BReast CAncer gene 1) or BRCA2 (BReast CAncer gene 2), (henceforth, BRCA1/2 mutation) without a diagnosis of breast or ovarian cancer (unaffected), have up to 80% increased lifetime risk of developing breast cancer, and up to 40% increased lifetime risk of ovarian cancer. Genetic counseling and testing based upon family history is essential to diagnose genetic mutations increasing one’s risk for certain cancers. Latinas have the second highest prevalence of BRCA1/2 mutations after Ashkenazi Jewish women, and cancer is now the leading cause of death among Latinos, surpassing cardiovascular disease. However, no qualitative study has been …

Improving The Consistency And Accuracy Of Depression Screening Using The Phq-9 In A Behavioral Health Facility, Adaku Anike

Walden Dissertations and Doctoral Studies

Depression is one of the most common psychiatric illnesses and one of the main causes of disability globally. Currently, at behavioral care facility patients are not consistently screened during the initial and follow-up visits due to limited staff knowledge in using the Patient Health Questionnaire-9 (PHQ-9) screening tool. Evidence-based literature recommends depression screening be done at every initial and follow-up visit. The PHQ-9 tool is valid and reliable for identifying, diagnosing, and monitoring depression treatment outcomes. Inadequate use of the PHQ-9 tool can lead to several negative patient outcomes. The project practice-focused question was: Does comprehensive education increase the knowledge …

The Lived Experiences Of Prediabetes And Type 2 Diabetes Among African Americans In Rural West Virginia, Orlando Craighead

Walden Dissertations and Doctoral Studies

African Americans in rural Appalachian West Virginia experience disproportionate rates of diabetes, with limited research examining their unique challenges in managing this chronic condition. This qualitative study aimed to explore how African Americans in rural Appalachia develop and utilize diabetes management skills, examining the intersections of cultural influence, healthcare access, and technological adoption. Using a hermeneutic phenomenological approach grounded in the Social Determinants of Health theory, Health Belief Model, and Social Ecological Model, semi-structured interviews were conducted with nine African American adults diagnosed with pre-diabetes or Type 2 diabetes in Kanawha County. Thematic analysis revealed four main themes: Cultural and …

An Educational Intervention Focused On The Care Of Older Adults, Michele Orzehoski

Walden Dissertations and Doctoral Studies

It is estimated that by 2050, individuals ages 65 and older will comprise 20% of the U.S. population. Further, research has demonstrated that among these aging adults, 80% have one chronic condition with 77% having at least two chronic conditions. Given this, the Institute for Healthcare Improvement (IHI) developed the Age-Friendly Health System framework for the care of older adults centering on what matters, medication, mentation, and mobility, or the 4Ms. In the local organization, leadership determined there was a need for an older adult-centered care model given their population includes aging individuals. Thus, the purpose of this doctor of …

Violence Among Nigeria’S Female And Predictors Of Help-Seeking Behavior Using Technology, Abayomi Karunwi

Walden Dissertations and Doctoral Studies

The decision-making autonomy of female intimate partner violence (IPV) survivors to make financial transactions is a stronger predictor of help-seeking behavior that is not yet fully explored. Despite the plausibility of using the mobile phone for financial transactions, it is yet to be explored as a predictor of help-seeking behavior after IPV events through digital financial inclusion. The dataset from the 2018 Nigerian Demographic Health Survey was used to explore if digital financial inclusion could predict help-seeking behavior instead of the severity of abuse among ever-partnered Nigerian female IPV survivors (aged 15 to 49 years) who use their mobile phones …

Developing The Evidence-Based Plan To Implement The Violence Assessment Tool, Yue Zhang

Doctoral Dissertations & Projects

Patient violence against healthcare workers is a prevalent issue in healthcare settings, manifesting through physical assaults, harassment, intimidation, or other disruptive behaviors occurring at the workplace. Workplace violence (WPV) can lead to healthcare worker burnout, decreased job satisfaction, and increased staff turnover. Various strategies exist to prevent WPV, with assessment tools being among the effective measures. This paper aims to develop an evidence-based plan for integrating the Violence Assessment Tool (VAT) into nurses’ daily practices to evaluate patients and reduce the risk of violent incidents.

Awareness Of Sleep Health In A Military Treatment Facility, Cristina Brock De Jesus

Walden Dissertations and Doctoral Studies

Sleep disturbances are reported in almost one-third of military personnel deployed in support of Overseas Contingency Operations (OCO), resulting in approximately 600,000 military personnel and veterans with clinically relevant sleep conditions (Mysliwiec et al., 2013). This study assesses how implementing staff education will increase awareness and impact patients' sleep health in an overseas treatment facility. The project demonstrated after implementing several staff education courses for the nursing personnel (n=22), knowledge and confidence improved by 33%. The initiative shows an enhanced staff understanding of sleep health, which impacts the recognition of sleep members with sleep-related concerns.