Nursing Commons^™

Exploring The Relationships Between Emotional Intelligence, Perceived Organizational Support, Job Satisfaction, And Intent To Stay Among Minnesota School Nurses, Kristin K. Coudron

Dissertations, Theses, and Projects

School nurses face escalating job demands driven by increasing student health complexity, chronic condition management, and expanding public health responsibilities. Often serving as the sole healthcare professional within a school or district, they work in settings characterized by high autonomy, variable organizational support, and growing concerns about job satisfaction and retention. Limited empirical research has examined how personal and organizational resources jointly relate to school nurses’ intent to remain in practice. Guided by the Job Demands–Resources (JD–R) theory and the National Association of School Nurses School Nursing Practice Framework, this quantitative, correlational, cross-sectional study explored relationships among emotional intelligence, …

The Impact Of Virtual Discharge Interventions Compared To Traditional Methods On Adult Patient Population Readmission Rates: An Integrative Review, Tiffany Providence, Carrie Brooks, Nannono Kayondo, Courteney Lovell, Alice Smith

Master's Projects

Hospital readmissions are a persistent quality and cost burden to the healthcare system, prompting evaluation of modern strategies to strengthen transitional care. This integrative review synthesized findings from thirteen studies published between 2011 and 2025 to assess the effectiveness of virtual discharge interventions in reducing readmission rates among adult patients. Virtual discharge interventions included programs utilizing technology, such as phone calls, video visits, apps, or remote monitoring, to help patients understand their care and improve positive outcomes. Many of these studies showed that virtual support can reduce hospital readmissions, especially for people with heart failure. Some programs also improved patients’ …

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Improvements Upon Reprocessing Of Orthopedic Single-Use Instruments, Alyssa P. Nguyen

Master's Projects and Capstones

Internal Medline data for Hospital A, a level I academic trauma center, identified a quality gap due to improper segregation and underutilization of orthopedic single-use device reprocessing bins. The baseline reprocessing rate of 4% for orthopedic products results in missed sustainability opportunities, financial strain, and increased regulated waste. A proposed quality improvement intervention implemented updated communication strategies, visual management tools, and education modules to reinforce current reprocessing workflows and close knowledge gaps. Outcome measures include the percentage of SUDs collected for reprocessing, survey results on reprocessing awareness, and potential financial savings in Appendix I. Early data showed a 10% year-to-year …

Proactive Recognition Of Patient Violence Risk: Enhancing Emergency Department Staff Awareness Through Structured Education, Lindsey Frasure

Doctoral Projects

Background: Workplace violence is a significant concern in emergency departments (EDs), where early recognition of behavioral and situational warning signs may help prevent escalation. However, warning signs may be missed, misinterpreted, or recognized too late.

Purpose: This project evaluated a structured educational intervention designed to improve ED staff knowledge of early warning signs and risk factors associated with patient violence. Lewin’s Change Theory guided the project.

Methods: A quasi-experimental pre-/post-intervention design was conducted with 10 ED staff members. Participants completed baseline assessments of knowledge and confidence, received structured education on violence risk factors and early warning signs, and completed post-intervention …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

Development Of A Standardized Evidence-Based Onboarding Process For Primary Care Providers In A Rural Health Setting, Corrie Goodier

Doctoral Scholarly Projects & Capstones

Primary care in the United States continues to face a critical provider shortage. This shortage is especially elevated in the rural regions of the country and is exacerbated by longstanding issues with subpar onboarding and high turnover rates. Failure to retain advanced practice providers in rural primary care settings further diminishes patient access to services, negatively impacts continuity of care, and complicates efforts to maintain patient trust in the nation’s delicate healthcare system.

Improved provider orientation and support processes within rural healthcare systems have the potential to increase satisfaction rates and productivity. The purpose of this DNP scholarly project was …

The Benefits And Barriers To Expanding Crna Programs In Michigan, Grace Van Zweden

Honors Theses

The demand for Certified Registered Nurse Anesthetists (CRNAs) and their delivery of safe, high-quality anesthesia care has increased significantly due to nationwide anesthesia provider shortages and the growing reliance on CRNAs to meet healthcare system needs. This demand underscores the importance of expanding nurse anesthesia programs in Michigan and across the United States to support nurses pursuing advanced education and to improve patient access to essential care within their communities. The CRNA profession has evolved over time to meet the changing needs of the healthcare system, and current CRNA programs require applicants to satisfy rigorous and highly specific admission criteria. …

Program Proposal For Improving Treatment Plan Participation At A Residential Treatment Center, Christal Carr

Walden Dissertations and Doctoral Studies

This is an executive leadership system improvement project that aspires to improve patient participation in their treatment plan of care (POC) at a residential treatment center (RTC). Facility data has identified a practice problem with a drop in treatment plan participation rates through decreased group attendance of 36 percent. This project is important to the nursing practice since patients that are active in their individual treatment plans stay to complete treatment. This project aims to address the practice-focused question: Among adults in a residential treatment program, what is the impact of implementing a Patient Ambassador (PA) Program on treatment plan …

Staff Education To Improve Clinician Knowledge And Self-Reported Confidence Regarding Transcranial Magnetic Stimulation, Little Neal Felton Jr.

Walden Dissertations and Doctoral Studies

This is a Doctor of Nursing Practice (DNP) staff education project to address the identified practice problem of variability in interdisciplinary behavioral health clinicians’ knowledge and self-reported confidence regarding transcranial magnetic stimulation (TMS) for treatment-resistant depression (TRD). Informal needs assessment findings and stakeholder consultations identified inconsistent familiarity with TMS and neuromodulation therapies. The practice-focused question was “According to the evidence, among interdisciplinary behavioral health clinicians in an outpatient behavioral health setting, what is the impact of a structured TMS educational intervention on clinician knowledge and self-reported confidence regarding evidence-based neuromodulation therapies?” The project implemented and evaluated structured education to address …

Improving Nurses’ Continence Care Knowledge, Care Planning, And Documentation Through Tailored Continence Care Education In A Rehabilitation Unit, Carolyn Richardson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project implemented and evaluated an algorithm-based educational intervention to improve nurses' continence care knowledge, care planning, and documentation on a rehabilitation unit. Driven by local data linking inconsistent care practices to recurring, toileting-related patient falls, the project utilized the Registered Nurses’ Association of Ontario (RNAO) Urinary Incontinence Care Algorithm/Toolkit as the core framework to provide comprehensive education to the nursing staff. Guided by the Johns Hopkins implementation model over a five-week period, the project measured success by comparing 20 pre- and 20 postintervention nursing documentation audits alongside pre- and posttests administered during …

Staff Education To Improve Integration Of Brief Cognitive Behavioral Therapy Into Outpatient Psychiatric Medication Management, Adanma Prisca Waller

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) staff education project addressed a clinical practice gap in an outpatient psychiatric setting. Routine psychiatric visits emphasized medication management, symptom evaluation, side-effect monitoring, and follow-up planning, while evidence-based brief cognitive behavioral therapy (CBT) micro interventions were not delivered through a structured, consistent clinical workflow. To address this gap, an education project was developed and implemented for outpatient psychiatric providers, including psychiatric-mental health nurse practitioners (PMHNPs) and clinical psychiatric staff. The project question asked if a structured educational intervention on brief CBT integration would improve providers' knowledge regarding implementation of brief CBT tools. Ten providers …

Improving Medication Reconciliation Within 24 Hours Of Admission In A Skilled Nursing Facility, Temitope Ifelowo

Walden Dissertations and Doctoral Studies

This evidence-based quality improvement project addresses inconsistent completion of medication reconciliation (MR) within 24 hours of admission among short-stay residents in a skilled nursing facility. A retrospective manual review of eligible admission records identified a practice gap: Only 50% of MRs were completed within 24 hours of admission at baseline. This gap in timely MR completion increases the risk of medication errors and rehospitalizations, underscoring timely completion as a patient safety priority. The practice-focused question was as follows: In short-stay residents admitted to a skilled nursing facility, how does implementing a standardized MR workflow, compared with usual practice, affect the …

Staff Education To Improve Nurse Knowledge Of Delirium And Dementia In Acute Care, Amanda Ann Newton

Walden Dissertations and Doctoral Studies

No abstract provided.

Implementing Routine Depression Screening In Primary Care, Rita Agunobi

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) organizational change project addressed inconsistent depression screening among adult patients in a primary care clinic. The project implemented an evidence-based practice change because nurses support patient assessment, documentation, and communication of findings to providers. Before implementation, formal screening was primarily limited to new patients and annual physical examinations. The practice-focused question examined whether implementing routine Patient Health Questionnaire-9 (PHQ-9) depression screening for eligible adult patients in a primary care clinic would increase depression screening rates over 8 weeks compared with current practice. The purpose was to implement routine PHQ-9 screening and evaluate screening rates. …

A Program Proposal For Evidence-Based Interventions To Drive Appointment Compliance, Chaketa Tillman

Walden Dissertations and Doctoral Studies

In a small mental health clinic, a practice problem of patients not showing up for scheduled appointments exists. The impetus for a change in the organization is the presence of high no-show rates (approximately 28%) in the outpatient mental health clinic, which negatively impacts patient outcomes, continuity of care, and clinic efficiency. The purpose of this DNP project was to develop a program proposal to support appointment compliance. A literature search was conducted using multiple search engines, revealing best practices for improving patient attendance. The practice-focused question was as follows: Will the development of a program proposal for evidence-based initiatives …

Program Proposal For The Implementation Of A Standardized Case Management Model, Vinteerie St. Louis

Walden Dissertations and Doctoral Studies

This evidence-based Doctor of Nursing Practice executive leadership system quality improvement project addresses inconsistent referrals to case management for discharge planning within a large public acute care hospital. The practice-focused question asks: According to the evidence, among hospitalized adult patients who meet defined high-risk discharge criteria, what is the impact of implementing a standardized early case management referral protocol requiring referral within 48 hours of admission on referral timeliness? A systematic literature search was conducted using CINAHL, MEDLINE (PubMed), Google Scholar, and the Cochrane Library. The search yielded 5,755 records; after removal of 1,200 duplicates, 4,555 records underwent title and …

Program Proposal To Standardize The Postpartum-To-Primary Care Transition For Patients With A Hypertensive Disorder Of Pregnancy, Monique Davis Williams

Walden Dissertations and Doctoral Studies

Postpartum patients frequently experience a fragmented transition from obstetric (OB) to primary care (PC), a gap linked to missed chronic disease management and, for patients with a hypertensive disorder of pregnancy (HDP), elevated long-term cardiovascular risk. This EBP quality improvement project asked whether an EHR-triggered automatic notification and structured warm handoff from the OB provider to the PCP, compared to current unstructured, patient-initiated transition, improves the rate of primary care follow-up visit attendance within 90 days of the postpartum visit. A systematic search of PubMed, CINAHL, and health policy sources (2020–2026) yielded ten sources appraised using the Johns Hopkins Evidence-Based …

Staff Education To Improve Suicide-Risk Assessment Response, Lovette Ndubisi

Walden Dissertations and Doctoral Studies

This quality improvement (QI) project addressed inconsistent suicide risk assessment and response using the Columbia-Suicide Severity Rating Scale (C-SSRS) on an adult inpatient psychiatric unit in a southwestern U.S. medical center. Identified practice gaps included inconsistent assessment across shifts, documentation, observation-level decisions, and communication. Because nurses play a central role in identifying and responding to suicide risk, improving knowledge, attitude, and consistency contributes to patient safety. The practice-focused question examined whether structured staff education using a suicide risk response reliability bundle would improve nursing staff knowledge and attitude in the use of C-SSRS in reassessment of patients’ suicide risk in …

Optimizing The Primary Care Nurse Role Through Standardization Of Competencies, Tabitha Zindel

Walden Dissertations and Doctoral Studies

Primary care within family health teams in Ontario, Canada continue to face increasing pressure from rising chronic disease prevalence, growing patient complexity, and limited access to timely care. Within this context, the RN functioning as the Primary Care Nurse Clinician (PCNC) plays a critical role in chronic disease management. However, the PCNC role remains inconsistently defined and is often underutilized, limiting scope of practice, reducing team efficiency, and contributing to gaps in care delivery. This DNP project is about an evaluation of an evidence-based practice translation/practice change initiative. The purpose of this project was to conduct an evaluation of the …

Staff Education To Improve Provider Knowledge And Confidence In Continuous Glucose Monitoring Utilization, Tierra Quiana Smith

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) staff education quality improvement project to address inconsistent knowledge and confidence regarding continuous glucose monitoring (CGM) among primary care providers and support staff in a federally qualified health center. The practice-focused question examined whether evidence-based CGM education influenced staff knowledge and confidence in recommending and implementing CGM for adults with uncontrolled Type 2 diabetes. Guided by the Johns Hopkins evidence-based practice model, the project included an interdisciplinary education session, quick-reference and insurance coverage resources, troubleshooting guidance, and anonymous pre- and posteducation assessments. On September 28, 2026, 19 of 21 eligible interdisciplinary staff …

Staff Education To Improve Medical Surgical Nurses’ Knowledge, Confidence, And Intent To Use Teach-Back For Medication Side-Effects, Christina Turner

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement staff education project addressed inconsistent nurse-delivered medication side-effect education and limited use of the teach-back method on a medical-surgical unit. Organizational Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) communication measures identified opportunities to improve patient understanding of medications and their potential side effects. The purpose of this project was to determine whether education for medical-surgical nurses on standardized nurse-delivered bedside medication side-effect education using the teach-back method improved nurses' knowledge, confidence, and intent to use teach-back with their patients. The project was guided by the Johns Hopkins nursing evidence-based practice …

Structured Education To Strengthen Nurse-Led Delirium Prevention And Management In The Emergency Department, Alicia Brianna Mitchell

Walden Dissertations and Doctoral Studies

I designed this Doctor of Nursing Practice (DNP) staff education project to strengthen emergency department (ED) nurses’ ability to identify delirium in older patients. The ED is a high-risk environment for delirium, particularly among older adults and those with complex medical conditions. However, nurses often lack structured education on delirium prevention and management. I aimed to close that gap by providing targeted evidence-based education to improve prevention, early recognition, and intervention, ultimately enhancing care quality and patient outcomes. The guiding practice-focused question for this project was: In a community hospital emergency department, what is the impact of a targeted educational …

Project Proposal To Integrate A Mobile Health Clinic To Improve Access To Care: County Health Department Health Equity Initiative, Santana Maria Robinson

Walden Dissertations and Doctoral Studies

The facility faces common challenges that include funding shortages, uninsured or public versus private insurance, limited or no transportation, and increased utilization of emergency or urgent care services versus preventive, primary care treatment, thus creating a widespread practice problem. The practice-focused question is: “in vulnerable or marginalized populations, how does mobilized access to care increase compliance for preventive medicine, screenings, and primary care services to improve health outcomes and quality of care over a 3-month period?” The summary of literature from peer reviewed journal articles within the last 5 years supports the implementation of a mobile clinic van to improve …

Nurse Professionals’ Perceptions Of Childhood Poverty And Its Impact On Southern Appalachian Children’S Mental Health, Katelyn Brooke Gilmore

Walden Dissertations and Doctoral Studies

Childhood poverty is a social determinant of health associated with adverse mental health outcomes among children, yet limited research has examined this relationship from the perspectives of nurse professionals working in Southern Appalachia. The purpose of this basic qualitative study was to explore nurse professionals’ perceptions of the influence of childhood poverty on children’s mental health in Southern Appalachia. Maslow’s hierarchy of needs served as the theoretical framework. Semi-structured interviews were conducted with 10 licensed nurse professionals who worked with children in the region, and data were analyzed thematically using ATLAS.ti. Three overarching themes emerged: (a) poverty creates unmet needs …

Provider And Clinical Staff Knowledge And Confidence In Recognizing, Screening For, And Managing Diabetes Distress, Hermanda Robinson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project addressing inconsistent recognition and response to diabetes distress among adults with type 2 diabetes at a primary care/endocrinology office in Virginia. Diabetes distress can interfere with self-management and quality of life, but nurses and advanced practice nurses can address this gap by assessing treatment barriers, providing education, and coordinating referrals. The practice-focused question asked whether evidence-based staff education would improve provider and clinical staff knowledge and confidence in recognizing, screening for, and managing diabetes distress. The purpose was to implement and evaluate education on diabetes distress, the Diabetes …