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Articles 481 - 510 of 2607
Full-Text Articles in Nursing
Improving Healthcare Providers’ Knowledge On Heart Failure Self-Care Management, Linda Nkeiruka Ukwu
Improving Healthcare Providers’ Knowledge On Heart Failure Self-Care Management, Linda Nkeiruka Ukwu
Walden Dissertations and Doctoral Studies
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Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene
Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addresses the pervasive health issue of burnout among healthcare providers, focusing on a community mental health clinic where internal data revealed high levels of staff turnover, absenteeism, medication errors, financial constraints, poor patient outcomes, and low staff satisfaction. Shortage of healthcare providers, exposure to patient trauma, high emotional demands, and administrative burdens are the systemic stressors of burnout at the project site mental health facility. These factors collectively underscored the need for a system-wide burnout reduction program to safeguard provider well-being and ensure the delivery of high-quality patient care and safety.
Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay
Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay
Walden Dissertations and Doctoral Studies
Summary This DNP staff education project focused on improving staff knowledge on self-care management of hypertension. The overarching patient care problem at the project site was uncontrolled hypertension among adult patients with lack of staff knowledge and confidence in delivering related patient education. Addressing uncontrolled hypertension is vital within nursing practice due to its impact on public health and the opportunity for a nurse-led evidence-based intervention to improve patient outcomes. The practice-focused question for this project was: “In adults with uncontrolled hypertension, does staff education program on hypertension self-care management improve staff knowledge on how to educate patients on self-care …
Evaluating The Compliance Of A Patient-Centered Daily Care Plan In An Acute Care Setting, Abigale Tzu
Evaluating The Compliance Of A Patient-Centered Daily Care Plan In An Acute Care Setting, Abigale Tzu
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) quality improvement evaluation project addressed inconsistent use of the Patient-Centered Daily Care Plan at a local acute care hospital. The problem was a gap in compliance with California Title 22 requirements, creating risk for survey deficiencies and limiting interdisciplinary communication. The purpose of this project was to evaluate whether the revised daily care plan improved individualized documentation and organizational compliance. De-identified aggregate data from pre-implementation (August–October 2023) and post-implementation (June–August 2024) periods were analyzed descriptively. Results showed a meaningful improvement in checklist completion, with compliance increasing from 94.8% to 97.3%. These findings demonstrated stronger …
Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri
Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri
Walden Dissertations and Doctoral Studies
Universal staff training to increase the validity and reliability of adolescent mental health screening was implemented in this quality improvement (QI) initiative. Depression and anxiety disorders often emerge between ages 12 and 17, yet evidence-based screening measures such as the Patient Health Questionnaire (PHQ-9/PHQ-9M) and Generalized Anxiety Disorder (GAD-7) are underutilized due to provider knowledge gaps, workflow inefficiencies, and cultural barriers. Guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, the project evaluated whether structured staff education improved early identification and diagnosis of adolescent depression and anxiety compared to routine practice. In workshops, web-based learning modules, case simulations, and …
Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross
Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross
Walden Dissertations and Doctoral Studies
Summary This doctoral, practice-focused quality improvement project used a mixed-methods design to evaluate the usability, acceptability, and clinical integration of a nutrition screening tool in a mental health outpatient clinic. The project addresses a key practice gap, the lack of evaluation of the implementation of a systematic nutrition screening for individuals with severe mental illness (SMI), which contributes to worsening psychiatric symptoms and delayed recovery. Aligning with nursing’s holistic and patient-centered framework, the initiative aimed to strengthen interprofessional collaboration and preventive care. The guiding practice-focused questions addressed: How usable and acceptable is the clinical practice guideline (CPG) tool among clinic …
Development And Implementation Of A Treatment History And Authorization Checklist To Improve Access To Spravato Therapy For Treatment-Resistant Depression, Margaret Mae Scott
Development And Implementation Of A Treatment History And Authorization Checklist To Improve Access To Spravato Therapy For Treatment-Resistant Depression, Margaret Mae Scott
Walden Dissertations and Doctoral Studies
Background: Treatment-resistant depression (TRD) presents a significant clinical and administrative challenge, delaying access to evidence-based therapies such as intranasal esketamine (Spravato). Inconsistent documentation and lack of standardized clinical pathways contribute to insurance authorization delays, exacerbating health inequities and care fragmentation. Purpose: This DNP project aimed to develop and implement a standardized Treatment History Checklist and Clinical Practice Guideline to streamline documentation, support timely insurance authorization, and promote equitable access to Spravato therapy for patients with TRD. Methods: Using a systems change framework, the project employed gap analysis, stakeholder engagement, and iterative validation to design tools aligned with payer requirements and …
Executive Leadership System Improvement: System- Level Program To Improve Care For Type-Ii Diabetic Patients, Jane Chukwura
Executive Leadership System Improvement: System- Level Program To Improve Care For Type-Ii Diabetic Patients, Jane Chukwura
Walden Dissertations and Doctoral Studies
The DNP Scholarly Project presents the Diabetes Interprofessional Management Program, an organization-wide, logic-model–driven initiative to improve glycemic control, empower self-management, and advance health equity for adults with type II diabetes. The project leverages an interprofessional team, targeted training, culturally tailored education, health technology tools, and community partnerships to translate resources into team-based care, personalized plans, self-management support, and continuous education, with outputs including trained staff, engaged patients, and standardized care protocols. Short-term outcomes center on reduced mean HbA1c, more patients achieving HbA1c <7%, and widespread adoption of evidence-based pathways with standardized testing cadences. Long-term outcomes focus on fewer complications, higher patient satisfaction, and reduced disparities through the expansion of Diabetes Self-Management Education (DSME) and culturally appropriate resources, underpinned by robust data governance. The evaluation and implementation plan measures clinical outcomes, patient experience, and equity over 0–24 months, using formative metrics (workflow deployment, training, testing timeliness, DSME referrals, portal use) and summative metrics (HbA1c changes, HbA1c <7% at 12 months, hospitalizations, complications, knowledge and quality of life, equity indicators, and ROI). Governance features a Data Steering Subcommittee and quarterly dashboards. Deliverables include standardized protocols, DSME curricula, EHR workflows, training, and a scalable, sustainable model for broader deployment.
Executive Summary: Clinical Practice Guideline Guideline For Identifying Patients At Risk For Posttraumatic Stress Disorder (Ptsd), Doris Chinazo Dibia
Executive Summary: Clinical Practice Guideline Guideline For Identifying Patients At Risk For Posttraumatic Stress Disorder (Ptsd), Doris Chinazo Dibia
Walden Dissertations and Doctoral Studies
In this Doctor of Nursing Practice (DNP) project, I developed a clinical practice guideline to address the absence of a standardized process for identifying adult outpatients at risk for posttraumatic stress disorder (PTSD) in a community-based mental health clinic. Without such a process, delays in trauma-focused care and inconsistent referrals may occur. The evidence base supports the use of brief, validated screening tools, such as the Primary Care PTSD Screen for DSM-5, for accurate risk identification in routine practice. The practice-focused question that I used to guide this project was: Will an evidence-based guideline for PTSD risk identification be approved …
Staff Education To Improve Provider Knowledge On Antibiotic Prescribing, Jessica Nicole Jaimez
Staff Education To Improve Provider Knowledge On Antibiotic Prescribing, Jessica Nicole Jaimez
Walden Dissertations and Doctoral Studies
Summary This Doctor of Nursing Practice (DNP) staff education project addressed a gap in guideline-based antibiotic prescribing among advanced practice registered nurses (APRNs) in an urgent care setting. The practice problem identified at the local project site was inconsistent adherence to Centers of Disease Control and Prevention (CDC) outpatient stewardship expectations, resulting in unnecessary antibiotic use for viral conditions and contributing to antimicrobial resistance. The practice-focused question for this project was as follows: In urgent care APRNs, does implementing a staff education program on guideline-based antibiotic prescribing improve provider-reported knowledge on antibiotic prescribing use? The purpose of this doctoral project …
Depression Screening In Veterans And Active-Duty Service Members With Chronic Pain, Lynelle Marie Endsley
Depression Screening In Veterans And Active-Duty Service Members With Chronic Pain, Lynelle Marie Endsley
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project addressed the absence of evidence-based depression screening among military members and veterans with chronic pain. Contrary to national guidelines, no standardized depression screening process was in place. This gap in practice was attributed to inadequate staff knowledge and understanding in using such tools. The purpose of this project was to evaluate whether staff education on the Patient Health Questionnaire-9 (PHQ-9) improved knowledge and confidence, in evaluating for and identifying depression in a high-risk population. The practice-focused question asked: Will staff education on the importance and consistent use PHQ-9 increase knowledge and confidence in depression …
Development Of An Evidence-Based Educational Intervention To Advance Nurse Knowledge In Comprehensive Care Of Patients With Congestive Heart Failure, Jessica Smith
Walden Dissertations and Doctoral Studies
The Doctor of Nursing Practice (DNP) project was a staff education intervention to increase nursing staff knowledge. Congestive heart failure (CHF) remains one of the leading causes of hospitalizations and has the highest readmission rates within 30 days of a previous admission. Consistent evidence reveals improving nursing knowledge reduces complications, improves self-management support, lowers readmission rates in this particular patient population. The DNP project was developed as a staff education intervention and focused on 30 nurses working on a telemetry unit in an acute care hospital. The project question was whether an educational intervention would increase general nursing knowledge caring …
Structured Follow-Up After Outpatient Visits: A Clinical Practice Guideline, Jeanette Serrano
Structured Follow-Up After Outpatient Visits: A Clinical Practice Guideline, Jeanette Serrano
Walden Dissertations and Doctoral Studies
I conducted this Doctor of Nursing Practice (DNP) project to develop an evidence-based clinical practice guideline (CPG) to reduce missed follow-up appointments and improve care continuity in a family medicine outpatient clinic. Missed follow-ups, especially common in underserved populations, compromise safety, delay treatment, and increase costs. The purpose of this doctoral project was to develop and appraise a CPG that integrates evidence-based strategies to improve follow-up procedures, reduce missed appointments, and enhance patient safety and care continuity in an outpatient setting. This project addressed the practice-focused question: Will a CPG around structured follow-up for patient visits in an outpatient clinic …
Executive Summary: Staff Education Project Staff Education To Close A Knowledge Gap Regarding Restraints, Aaron Ross Ledbetter
Executive Summary: Staff Education Project Staff Education To Close A Knowledge Gap Regarding Restraints, Aaron Ross Ledbetter
Walden Dissertations and Doctoral Studies
The purpose of this Executive Summary is to address a gap in knowledge that I attempted to close regarding restraint utilization. Restraints, both physical and chemical, have been prevalent over the past ten years and with their increased utilization during the pandemic which has continued post-pandemic. Nursing as a culture has become more reliant on restraints as it allows more time for nurses to provide care elsewhere. Both physical and psychological complications have been recognized during the utilization of physical restraints. Their prominence, although helpful with time constraints for nurses, have shown to negatively impact the patients who they are …
Staff Education To Improve Medicare Lung Cancer Screening And Processes, Ashley Mccammon
Staff Education To Improve Medicare Lung Cancer Screening And Processes, Ashley Mccammon
Walden Dissertations and Doctoral Studies
The doctoral project was a staff education initiative to address underutilization of low-dose computed tomography (LDCT) lung cancer screening among Medicare-eligible patients at the project site. Lung cancer is the leading cause of cancer death, and LDCT screening reduces mortality by up to 20%. Internal data from the project site revealed that only 20.13% of eligible patients completed screening, underscoring the need for structured staff education to improve knowledge and support early detection. The practice focused question asked: Will a staff education on Medicare LDCT screening and processes increase staff knowledge towards the ultimate goal of increasing LDCT screening rates? …
Development Of An Evidence-Based Clinical Practice Guideline For Discharging Patients With Substance Use Disorder (Sud) From Outpatient Treatment To Community Care, Emmanuel Onyeani
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addressed a gap in practice in an outpatient treatment center for discharging patients with substance use disorder (SUD), addressing the need for follow-up care and relapse prevention due to the widespread impact of SUD. Clinical practice guidelines (CPG) help healthcare professionals make informed decisions for specific clinical situations. The guiding question asked whether an expert panel would evaluate and validate a CPG developed from current, evidence-based literature and recommendations with 70% agreement using the AGREE II tool. The CPG focused on continuity of care, access to resources, and relapse prevention strategies. Seven expert …
Enhancing Home Health Nursing Knowledge Through Targeted Education On Polypharmacy Risk Awareness In Older Adults, Chinyeaka Linda Ogbonna
Enhancing Home Health Nursing Knowledge Through Targeted Education On Polypharmacy Risk Awareness In Older Adults, Chinyeaka Linda Ogbonna
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) staff education initiative addressed the problem of polypharmacy, a common issue in home health care that increases the risk of drug interactions, side effects, and hospitalizations. Nurses and aides often provide daily care but may not recognize high-risk medications or warning symptoms. Addressing this gap was vital to nursing practice because staff are on the front line of patient monitoring and safety. The practice-focused question asked whether structured education for home health staff would improve knowledge of polypharmacy risks by 20%, increase recognition of high-risk medications by 75%, and result in at least 75% …
Enhancing Diabetes Self-Management Education And Support Knowledge And Awareness Among Nurses, Tamba Sam-Manimoi
Enhancing Diabetes Self-Management Education And Support Knowledge And Awareness Among Nurses, Tamba Sam-Manimoi
Walden Dissertations and Doctoral Studies
Diabetes mellitus (DM) affects 12% of the United States population at an annual cost of $412.9 billion. In the local clinic, 20% of the patient population has a diagnosis of DM. Despite the importance of diabetes self-management education and support (DSMES) in managing DM, patients are often not educated on this important strategy. Leadership identified that patients were reporting a lack of knowledge regarding DSMES practices and that the nurses lacked the necessary knowledge and awareness to educate patients in DSMES. Thus, the purpose of this DNP project was to determine if an educational intervention focused on DM and DSMES …
Enhancing Medication Adherence In Primary Care Settings Through Staff Education, Sabita Bhusal
Enhancing Medication Adherence In Primary Care Settings Through Staff Education, Sabita Bhusal
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project was an evidence-based staff education initiative addressing medication nonadherence in hypertension, a critical issue that contributes to poor health outcomes, uncontrolled blood pressure, preventable hospitalizations, and increased healthcare costs. The identified gap in practice was defined by limited staff knowledge, lack of structured training, and inconsistent application of evidence-based adherence counseling strategies. The practice-focused question was: In a primary care clinic, will an evidence-based staff education program on medication adherence increase staff knowledge? A structured training intervention was implemented and then evaluated for its effectiveness. Descriptive statistics and a paired t test comparing pre- …
Perspectives Of Nursing Faculty On The Barriers, Opportunities, And Teaching Strategies For Developing Peer Feedback Skills Among Entry-Level Nursing Students, Anna Kornienko
Walden Dissertations and Doctoral Studies
Peer feedback benefits nursing education and practice by fostering collegial relationships and promoting the quality of care, yet students often lack training to engage effectively. While existing research has examined student perspectives, the experiences and strategies employed by nursing faculty remain underexplored. The purpose of this qualitative study, guided by the student feedback literacy framework, was to explore the perspectives of nursing faculty on the barriers, opportunities, and strategies for developing peer feedback skills among undergraduate nursing students. Seventeen Canadian nursing faculty participated in semi-structured virtual interviews. Analysis revealed five themes that aligned with the study’s three foci: strategies (a) …
Staff Education To Enhance Therapeutic Communication In Community Clinic Settings, Marian Allen
Staff Education To Enhance Therapeutic Communication In Community Clinic Settings, Marian Allen
Walden Dissertations and Doctoral Studies
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Central Line-Associated Bloodstream Infection Prevention Staff Education For Medical- Surgical Nurses, Grace Ann Abustan Porciuncula
Central Line-Associated Bloodstream Infection Prevention Staff Education For Medical- Surgical Nurses, Grace Ann Abustan Porciuncula
Walden Dissertations and Doctoral Studies
Background: CLABSIs remain a significant cause of morbidity, mortality, and increased healthcare costs, particularly in hospitalized patients requiring long-term vascular access. Despite established guidelines, inconsistent adherence to central line dressing change protocols persists within the DNP project organization, often due to insufficient staff knowledge and variability in practice. This practice gap increases the risk of catheter site contamination and leads to preventable CLABSI events, creating a clear need for intervention. Method: A designed educational program that integrated interactive lectures, case studies, and simulation-based activities. A pre- and post-intervention assessment to measure changes in participants’ knowledge and self-reported confidence in applying …
Psychoeducation For Community Support Workers To Decrease No Call And No-Show Rates In An Outpatient Mental Health Facility, Promise Lum Ngongwashi
Psychoeducation For Community Support Workers To Decrease No Call And No-Show Rates In An Outpatient Mental Health Facility, Promise Lum Ngongwashi
Walden Dissertations and Doctoral Studies
Missed appointments remain a critical issue in health care, as they contribute to poorer patient health outcomes, treatment discontinuity, and increased system costs. Improving staff knowledge in this area is essential for ensuring timely, equitable, and effective patient care. This doctoral project was a staff education initiative designed to enhance community support workers (CSWs’) knowledge of methods for encouraging patient adherence to clinic appointments through psychoeducational training. The practice problem addressed was the inconsistency in staff use of evidence-based strategies to motivate and support patients in maintaining clinic attendance. The practice-focused question guiding the project was: Does psychoeducation improve CSWs’ …
A Clinical Practice Guideline For Managing Gastrointestinal Toxicities Related To Glp-1ra And Gip/Glp-1ra Medications, Lindsay Williamson
A Clinical Practice Guideline For Managing Gastrointestinal Toxicities Related To Glp-1ra And Gip/Glp-1ra Medications, Lindsay Williamson
Walden Dissertations and Doctoral Studies
The project is a Clinical Practice Guideline (CPG) for managing Gastrointestinal (GI) toxicities related to Glucagon-like Peptide-Receptor Agonist 1 (GLP-1RA) and Glucose-dependent insulinotropic polypeptide/Glucagon-like peptide-1Receptor Agonist (GIP/GLP-1RA) medications. Many patients are seeking weight loss with these agents, which cause GI toxicities that lead prescribers to have patients remain at lower doses that are sub-therapeutic or discontinue therapy. Advanced Practice Registered Nurses (APRNs) are prescribing these therapies for patients and lack an evidence-based CPG for properly managing the most common GI toxicities. APRNs can successfully monitor and manage GI symptoms to promote tolerability and treatment adherence. The project question focuses on …
Nurse Residency Program: Improving Staff Awareness Through Education, Cynthia Kay Butterman
Nurse Residency Program: Improving Staff Awareness Through Education, Cynthia Kay Butterman
Walden Dissertations and Doctoral Studies
Across the health care continuum, organizations face persistent nursing shortages and the challenge of integrating novice nurses into clinical practice, often with limited skills and underdeveloped critical thinking abilities. Nurse residency programs have been integrated by many facilities to provide support for new novice nurses in transitioning from academia to the professional nursing role. This quantitative, quasi-experimental research project was conducted at a community-based hospital with an existing 8- to 10-week nurse residency program that had very limited stakeholder involvement. The purpose of the project was to create an educational training module for key stakeholders to strengthen awareness of why …
Self-Management Experiences Of Heart Failure Patients Who Received Telehealth Services During The Covid-19 Pandemic, Christie Devine
Self-Management Experiences Of Heart Failure Patients Who Received Telehealth Services During The Covid-19 Pandemic, Christie Devine
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic increased the utilization of telehealth in managing chronic conditions such as heart failure. Existing research has primarily focused on patient experiences with specific telehealth platforms or settings, limiting generalizability within the diverse United States healthcare system. The purpose of this qualitative study, guided by the health promotion model, was to describe patient experiences with self-management of heart failure while receiving medical care through any type of telehealth service (e.g., telephone, video calls, remote monitoring) in the United States. Twenty-two participants were interviewed who met the criteria of having a diagnosis of heart failure and using telehealth since …
Staff Education To Improve Knowledge Of Venous Leg Ulcer Prevention, Bini John
Staff Education To Improve Knowledge Of Venous Leg Ulcer Prevention, Bini John
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) staff education project implemented a standardized program to strengthen knowledge, confidence, and adherence to venous stasis ulcer (VSU) prevention among staff in an outpatient vascular clinic. The practice problem was the lack of standardized staff education, leading to inconsistent patient teaching and recurrent ulceration. VSUs are a significant public health challenge, increasing morbidity, healthcare utilization, and reducing quality of life (He et al., 2024). The practice-focused question for this project was: In frontline medical staff at a vascular outpatient clinic, does a staff education program on a standardized approach to patient education for VSU …
Staff Education On Oral Health To Night Shift Staff, Uzoamaka Mbionwu
Staff Education On Oral Health To Night Shift Staff, Uzoamaka Mbionwu
Walden Dissertations and Doctoral Studies
Hospital-acquired pneumonia (HAP) remains the most common hospital-acquired infection in the United States, with nonventilated adult patients particularly at risk. This doctoral project focused on improving oral care practices among night shift nursing staff on a medical-surgical unit to reduce the risk of HAP. The practice gap identified was the inconsistent and inadequate delivery of oral hygiene during night shifts, primarily due to staff knowledge deficits, time constraints, and a lack of standardized procedures. The project was guided by the Johns Hopkins Evidence-Based Practice model and addressed the following question: In adult patients on a medical-surgical unit, will staff education …
Sociocultural Factors Influencing Excess Gestational Weight Gain In Pregnant Puerto Rican Women, Sonia O. Roselló Aponte
Sociocultural Factors Influencing Excess Gestational Weight Gain In Pregnant Puerto Rican Women, Sonia O. Roselló Aponte
Walden Dissertations and Doctoral Studies
More than 50% of women experience excessive weight gain during pregnancy or are overweight at the start of pregnancy, increasing their risk of short and long-term maternal and fetal complications. The literature highlights the relationship between sociocultural factors and excessive gestational weight gain (EGWG) and the need to explore these factors in ethnic subgroups. The purpose of this descriptive qualitative study, guided by Nola Pender’s health promotion model, was to explore the sociocultural factors that influence EGWG for pregnant women living in Puerto Rico. Semi-structured interviews were conducted with seven participants recruited from public and private prenatal clinics in Puerto …
Staff Education On Antibiotic Stewardship For Urgent Care, Darla Michelle Taylor
Staff Education On Antibiotic Stewardship For Urgent Care, Darla Michelle Taylor
Walden Dissertations and Doctoral Studies
This doctoral project focused on a staff education initiative designed to improve antibiotic stewardship among urgent care providers. It evaluated changes in provider knowledge and prescribing intent following an evidence-based educational intervention by asking, “Does staff education on antibiotic stewardship in an urgent care setting enhance knowledge when compared to pre- and post-education assessments?” The purpose was to increase provider knowledge, confidence, and adherence to stewardship principles while influencing prescribing intent. The project consisted of an educational presentation with pre- and post-education surveys. Data was collected using pre- and post-education surveys featuring Likert-scale items that measured provider confidence, knowledge, and …