Working With Patients Who Self-Injure: An Open Label Study Of An Educational Intervention To Upskill Emergency Nurses On Non-Suicidal Self-Injury, Penelope Hasking, Amanda Aiyana, Jonathon Burcham, Samantha Carey, Joanne M. Dickson, Daniel Fatovich, Logan Hopkins, Eme John, Shirley Mcgough, Chloe Mclean, Irene Ngune, Alex Wheeler

Research outputs 2022 to 2026

Non-suicidal self-injury (NSSI), deliberate damage to body tissue with no intent to die, is not engaged with suicidal intent but is the most reliable predictor of later suicidal behaviour. This makes efforts to reduce self-injury critical. Emergency departments can be the gateways to care for many people who have self-injured and optimal sites for interventions that promote recovery. However, emergency nurses have anecdotally reported that they lack training and feel ill-equipped to provide care for patients who self-injure. In this open label trial (where both participants and researchers were aware who received the intervention), all nurses in a metropolitan emergency …

Development And Validation Of Competencies For Home-Based Nursing Care: An E-Delphi Study, Khairul Dzakirin Bin Rusli, Ying Lau, Siew Tiang Lau, Laura Schmidt Tham, Michelle Mong Nee Kee, Qi Wen Ng, Shu Fen Ong, Karen Strickland, Sok Ying Liaw

Research outputs 2022 to 2026

Background: The expected competencies of nurses in home-based care remain unclear. A list of professional competencies that are agreed upon by a panel of content expert are needed to offer some form of standardized expectations among nurses and home-based care stakeholders. Objectives: To evaluate the content validity of the professional competencies identified for home-based nursing care. Design: An e-Delphi method was used. Settings: A purposive sampling of local and international experts in home-based nursing care or community nursing. Methods: Preliminary competency items were developed inductively from earlier studies and deductively by a steering committee. Sixteen experts performed two rounds of …

Support Networks And Care Needs: Insights From Older Vietnam-Born Australians Living With Chronic Disease, Thi Ngoc Minh Nguyen, Rosemary Saunders, Gordana Dermody, Lisa Whitehead

Research outputs 2022 to 2026

This study explored the support networks and care needs of older Vietnam-born adults living in Australia, using focused ethnography, and guided by Leininger's Culture Care theory. Data were collected through participant observation and in-depth interviews over 7 months in Perth, Western Australia, and analyzed thematically. Twelve participants were included. Two themes emerged: “The collectivist context of disease management” and “When in Rome, do as the Romans do.” Chronic disease self-management primarily took place within family and community settings, with ethnic communities playing a significant role. Migration-related stigma influenced perceived care needs, creating a gap between perceived and actual support. Findings …

A Farewell Message, Misty L. Rhoads

Journal of Transformative Touch

No abstract provided.

Enhancing Medication Adherence In The Older Adult By Implementing A Medication Program, Cathylee Nair

Doctor of Nursing Practice Final Project Abstract

PURPOSE The medication adherence program was a collaborative effort to develop, implement, and evaluate a medication adherence program that aims to reduce health utilization and disease exacerbation by improving medication adherence in older adults. The primary goal was to improve medication adherence by 10% within eight weeks.

BACKGROUND The medication adherence program was based out of a home health agency in Katy, Texas. Medicare utilizes home health agencies as patient support programs for providing services like medication management to reduce older adult’s health utilization and improve health outcomes at home.

METHODOLOGY The Plan Do Study Act (PDSA) model for improvement …

Evidence Based Pilot Project To Reduce Nurse Documentation Time In The Electronic Health Record, Herbert Rolito C. Ortiz

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement project was the reduction of electronic health record (EHR) documentation time and improve nurse satisfaction in an Intermediate Care Unit (IMU).

Introduction: Nursing documentation supports patient safety, interdisciplinary communication, and regulatory compliance. However, excessive documentation requirements may reduce the time nurses spend with patients, increase the risk of errors, and contribute to job dissatisfaction and burnout. At a large, academic hospital, nurses in the target unit were averaging 155 minutes of documentation per 12-hour shift, ranking in the 90th percentile for documentation time among peer institutions.

Methodology: The project, conducted between March 1 …

Enhancing Intimate Partner Violence Screening In Primary Care: A Staff Education And Quality Improvement Initiative, Izoduwa Asoro

Walden Dissertations and Doctoral Studies

This project addresses the often-overlooked epidemic of intimate partner violence (IPV) in primary care settings through a novel staff education and quality improvement initiative focused on transforming screening practices. A significant challenge in detecting IPV is the inadequate training of healthcare providers and the absence of rigorous screening measures, which leads to unmet patient needs and exacerbated trauma. By enhancing the knowledge of primary care staff regarding IPV and training them to effectively use validated screening tools, the initiative aims to improve detection rates. Analytical strategies, including pre-and post-training questionnaires and role play, were employed to evaluate the effectiveness of …

Educating Nurses On Healthy Coping Mechanism Following Workplace Violence Occurrences, Erin Jay

Walden Dissertations and Doctoral Studies

According to the American Nurses Association (ANA), healthcare workers are five times more likely to suffer a workplace violence (WPV) injury compared to workers in other industries. Given that nurses are the foundation of healthcare delivery, WPV is a cause for concern for most healthcare organizations. In the local organization, leadership has identified an increase in reported WPV occurrences among nurses. Given this, leadership agreed that an educational intervention focused on strategies to address WPV was warranted. Thus, the purpose of this doctor of nursing practice (DNP) project was to determine whether an educational intervention focused on healthy coping mechanisms …

Hypertension Literacy For Healthcare Providers, Maninder Kaur Dhaliwal

Walden Dissertations and Doctoral Studies

When medical staff lack sufficient training in hypertension literacy, it significantly impacts patient outcomes, expenses, and quality of life. Uncontrolled hypertension increases health care costs by causing frequent emergency room visits and hospital stays. After a thorough needs assessment, it was identified at the project site that nurse practitioners were not knowledgeable about the most recent recommendations for managing hypertension and patient education techniques. This practice gap was also contributed to by a lack of structured training and time for learning. The practice-focused question for this project was: Among health care staff, how does implementing a staff education initiative on …

Staff Education To Improve Knowledge Of Wound Documentation Skills Among Inpatient Nurses, Rouine Kay Patron Litorja

Walden Dissertations and Doctoral Studies

While many healthcare organizations have established wound documentation protocols, maintaining consistent, high-quality documentation remains a widespread challenge in clinical practice. In this staff education project, I addressed the implementation of a staff education program to increase nurses' knowledge about evidence-based practices regarding wound documentation. The staff education initiative was conducted in a medical telemetry unit, with 17 nurses participating. A pretest-posttest design was employed to evaluate the impact of the education. The aggregate pretest and posttest scores were analyzed using the Normalized Learning Gain (NLG) formula. The NLG gain of 0.37, equated to a 37% improvement in knowledge a moderate …

Improving Overall Quality Of Care Through Bedside Shift Reporting In Acute Care, Kimberly R. Reed Dnp

Quality Improvement & Patient Safety Forum

No abstract provided.

Improving Self-Reported Hydration Using Refillable Bottles And Clean Water Access, Erica Short, Adam Dill, Ali Bradley, Kaito Gao, Jennifer Hanks, Hayat Muhammad, Mai Ngo

Nursing Leadership in Community Engagement Projects

In Washington State, around 18.5% of individuals aged 12 and older, about 1.4 million people, struggle with substance use each year (Substance Abuse and Mental Health Services Administration, 2023). Many also face housing instability and limited access to basic health needs like clean drinking water. Our agency supports Seattle residents in recovery, and during our initial assessment, we identified inadequate hydration as a common concern. As a team of seven nursing students, we developed a community health project to improve self-reported hydration among this population. This paper outlines our process from assessment to intervention and our efforts to support healthier …

The Mediation Effect Of Resilience And The Moderation Effect Of Hospital Magnet Status On The Relationship Between The Practice Environment And Turnover Intentions Among Acute Care Nurses, Elizabeth Fraser

Graduate Doctoral Dissertations

ABSTRACT

THE MEDIATION EFFECT OF RESILIENCE AND THE MODERATION EFFECT OF HOSPITAL MAGNET STATUS ON THE RELATIONSHIP BETWEEN THE PRACTICE ENVIRONMENT AND TURNOVER INTENTIONS AMONG ACUTE CARE NURSES

May 2025

Elizabeth Helena Fraser, B.S.N., Elms College

M.S.N., Emmanuel College

Ph.D., University of Massachusetts Boston

Directed by Professor Sun S. Kim

The U.S. healthcare system has long suffered a critical nursing shortage, intensified since the coronavirus disease 2019 (COVID-19) outbreak. The shortage is a complex national crisis compounded by the high turnover of qualified nurses. Turnover is when a nurse leaves an organization for another nursing position or leaves the profession …

Staff Education Program On Strategies To Manage Disruptive Patient Behavior, Lazare Ngah Shadzeka

Walden Dissertations and Doctoral Studies

The practice concern was the absence of a consistent method of providing structured training on the management of disruptive patient behaviors to staff in a mental health ambulatory care clinic. This clinical gap is important because it heightens the risk of workplace violence, staff burnout, and suboptimal patient care outcomes. The doctoral project practice-focused question was, How does a focused staff education program on dealing with disruptive patient behavior impact nursing staff abilities and confidence in an outpatient clinic setting? Thus, the purpose of this doctoral nursing project was to develop and implement a staff education program aimed at enhancing …

Enhancing Health Literacy In Adolescents At A Homeless Shelter, Raymond Don N. Razon, Lauren Snedeker, Janice Ou, Chau V. Nguyen, Makenna Johnston, Ruweyda Salim, Garett W. Walters

Nursing Leadership in Community Engagement Projects

Enhancing Health Literacy in Adolescents at a Homeless Shelter

Over the past two months, our group of seven Seattle Pacific Nursing Students collaborated with a local nonprofit homeless shelter for families. After meeting with the agency’s health services coordinator, we decided to focus on the teen population and enhance their health literacy. This choice was due to our population primarily not being exposed to the American healthcare system. Our team gathered information from the teens and found that nutrition, sleep, and mental health were of particular interest. Based on this, we planned and implemented a health literacy intervention tailored to …

Hazing Prevention Education, Elianna Mielbrecht, Sky Agpawa, Ceirra Dean, Joseph Arinaza, Moses Hart, Lily Speakman, Hana Maow

Nursing Leadership in Community Engagement Projects

Hazing Prevention Education

Hazing in higher education is often hidden behind a culture of secrecy, tradition, or team-building. It includes any unwanted physical, emotional, or psychological activities that a person undergoes before joining a group that has clear lasting impacts on the person’s health, regardless of willingness to participate (H.R.5646 - Stop Campus Hazing Act, 2024; Boyer, A., n.d.). Seven nursing students partnered with a university’s campus security office in Seattle, Washington. This department is responsible for maintaining a safe and respectful campus environment, making it a key stakeholder in hazing prevention efforts.

Guided by the Stop Campus Hazing Act …

Opioid Use Disorder Within The Emergency Department: Not All Skin Infections Are Equal, Jennifer E. Pletcher

Graduate Doctoral Dissertations

The emergency department (ED) is where two health crises commonly converge, the opioid crisis and cellulitic infections while simultaneously being the front door to the healthcare system at large. The aim of this dissertation is to fill the gap in knowledge about specific skin and soft tissue injury and severe infection (SSTI) with comorbidity of opioid use disorder (OUD) (OUD SSTI) population and demonstrate inequities as compared to the SSTI and severe infection without OUD comorbidity (non-OUD SSTI) through the lens of the Conceptual Model of Nursology for Enhancing Equity and Quality: Population Health and Health Policy. The Nationwide Emergency …

Enhancing Staff Knowledge On Fall Prevention For Elderly Patients In Home Care Settings, Through Staff Education Initiatives, Anna Ngwafu

Walden Dissertations and Doctoral Studies

Summary Falls are one of the leading causes of injury for older patients in homecare settings, affecting patient safety and quality of care. Patient falls contribute to morbidity, mortality, and healthcare costs. A fall often results in injuries which can be fatal. Over 30% of individuals who are 65 years or older experience falls on an annual basis. In these older adults, the leading cause of death is unintentional falls. Although there are evidence-based strategies for preventing falls, there are still gaps in staff knowledge. The purpose of the DNP project was to develop, implement, and evaluate a staff education …

Building A Grounded Theory Of Resilience Among Survivors Of Chronic Ischemic Stroke, Erin Marie Tompkins Doan

Dissertations

Abstract

Stroke is disruptive with elusive recovery and adjustment. Beyond traditional aspects of stroke rehabilitation, literature suggests adjustment to stroke should also include intervention with focus on resilience. A gap exists between conceptualization, theoretical models, and strategies for supporting resilience in persons with chronic ischemic stroke. This three-manuscript dissertation research comprised a scoping literature review, a pilot study, and a phenomenological case study. We employed a convergent mixed methods design in which we implemented and studied outcomes of an adaptive mindfulness intervention. We implemented eight focus groups with eight adults and four individual interviews over 13 months. The Brief Resilience …

Staff Education To Improve Nurses’ Knowledge To Prevent Hospital-Acquired Pressure Ulcers/Injuries, Aarinola Abosede Omisola

Walden Dissertations and Doctoral Studies

The quality improvement education project aimed to address a significant increase in hospital-acquired pressure injuries (HAPIs) at a veteran medical center in Indiana, where statistics showed a 40% increase in Stage 2 pressure ulcers and a 60% increase in deep tissue injuries in Quarter 3 in 2023. Recognizing the serious complications associated with pressure injuries, along with their significant financial burden, the project aimed to answer the question: Will a staff education program focusing on an evidence-based, comprehensive approach to preventing pressure injuries increase nurses’ knowledge about implementing strategies to prevent them? The objective was to enhance adherence to the …

Optimizing The Psychiatric Referral Pathway Between Community Health Center Primary Care Partner And An Academic Medical Center Psychiatric Practice: Baseline Assessment Of The Current State And Needs, Katherine Verdier

Doctor of Nursing Practice Scholarly Projects

Background

The shortage of mental health professionals and the stigma associated with seeking mental health care has contributed to the need for primary care to provide mental health services. While primary care providers are well-placed to offer mental health treatment, they may not feel comfortable prescribing psychotropic medication in their practice. In the absence of full collaborative care models, consulting with psychiatric specialists can help primary care providers to manage mental health conditions in primary care.

Local Problem

At a community health center (CHC) in Worcester County, Massachusetts, primary care providers (PCP) provide mental health treatment for patients and have …

Reducing Stress Through Music And Meditation: A Low-Barrier Mental Health Intervention For Unhoused Women In Shelter Settings, Joan Katumo, Fiona Johnson, Jenny Tanner, Jamilah Salazar, Malica Richards, Hanna Sheikh, My Nguyen

Nursing Leadership in Community Engagement Projects

Reducing Stress Through Music and Meditation: A Low-Barrier Mental Health Intervention for Unhoused Women in Shelter Settings

Seven nursing students from Seattle Pacific University partnered with a women’s day center in downtown Seattle to support unhoused women experiencing chronic stress and systemic inequalities. The center serves as a safe and welcoming space where women can access essential services including hot meals, hygiene facilities, healthcare connections, and case management, all while fostering a sense of dignity, community, and personal agency. Many clients faced significant trauma and housing insecurity, which contributed to ongoing stress and health challenges, conditions often compounded by social …

Staff Education To Increase Knowledge And Education Of Urinary Tract Infection To Reduce Rehospitalization, Yia Lor

Walden Dissertations and Doctoral Studies

Urinary tract infections (UTIs) are considered the most common infections in healthcare, particularly in nursing homes. If appropriate preventive measures are taken, infection rates will be reduced. The DNP project aimed to enhance clinicians' knowledge to reduce and prevent UTIs in nursing homes. This knowledge expansion also significantly has potential to reduce the risk of unnecessary hospitalizations. A knowledge gap was identified that focused on the necessary preventive measures to impact patient outcomes positively. Addressing this in nursing is essential because it can help reduce mortality risks. The participants consisted of six registered nurses and six certified nurse assistants who …

Use And Interpretation Of Patient Health Questionnaire-9, Rufina Ewane

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to address the lack of knowledge on how to use and interpret the Patient Health Questionnaire (PHQ-9) tool. The practice problem highlights a knowledge gap, leading to the underutilization of the PHQ-9 tool for depression screening. This underutilization hinders timely diagnosis and effective management, presenting a significant challenge to achieving optimal patient outcomes. The project explores the question: Will implementing a staff education program on the use and interpretation of the PHQ-9 tool improve staff knowledge? The project was designed to enhance staff knowledge in utilizing and interpreting the PHQ-9 tool …

A Systematic Review Of Brief Cognitive Test Used Among The Veteran Population, Joel Mcpherson

Walden Dissertations and Doctoral Studies

The practice problem this DNP project addressed was the lack of a of consensus for a brief cognitive screening (BCS) tool that can be most predictive of mild cognitive disorder (MCI) and dementia in a Veteran Affairs (VA) outpatient clinic. Addressing this gap in practice is important because the veteran population may be at increased risk of MCI and dementia due to age, a history of traumatic brain injury, and posttraumatic stress disorder. This DNP project was a systematic review of the literature. A population, exposure, outcome (PEO) framework and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) theory guided …

Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason

Walden Dissertations and Doctoral Studies

In this staff education initiative, I focused on fall prevention in long-term care facilities (LTCFs) by reinforcing the Morse Fall Scale fall risk assessment tool. Falls in LTCFs are a significant concern, leading to injuries, hospitalization, and declining residents' quality of life. The practice problem stems from insufficient staff training, contributing to inadequate patient care and an increased risk of falls. The practice-focused question was used to explore whether education about fall prevention measures and guidelines improves long-term care nurses’ knowledge and intent to follow these guidelines; a total of 23 participants were involved in this project. Pre- and post-education …

Staff Education On Medicaid And Medicare Programs, Angela R. Smith

Walden Dissertations and Doctoral Studies

Case managers at the practice site are responsible for helping older and disabled clients receive services from Medicare and Medicaid. The gap in practice was that case managers were failing to recognize the benefit and eligibility differences between these federal and state-run programs. Case managers must be well-informed regarding these programs to effectively manage their clients’ care. The goal of this project was to plan, implement, and evaluate a staff education program on Medicare and Medicaid services. The practice-focused question centered on whether participants demonstrated increased knowledge about Medicare and Medicaid services available to Waiver Program clients. The theoretical framework …

Integrating An Sms Text Reminder Program For Smi Patients To Combat Provider Appointment No-Shows, Philip Spreter Bsn

Doctor of Nursing Practice Final Manuscripts

Abstract

We are in the digital age in all avenues of life, especially healthcare. The standard of care is no longer just a paper reminder card and a call from the office to confirm the patient is going to make it in the week of their appointment. Cards get lost and more people are screening their phones due to a rise in robocalls and scams, which is leading to more people corresponding via text. This is why text-based reminders are now the new, preferred standard for reminding patients of their appt. With that said, there appears to be a deficit …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

Parent’S Health Literacy And Stress Level In The Inpatient Pediatric Setting, Tina C. Smith

Dissertations

Purpose: This study examined the relationship between parent health literacy and stress levels during their child’s inpatient hospitalization.

Background: In 2019, over five million pediatric hospitalizations occurred in the United States. Parents are central to their child’s care, but stress and sociodemographic factors may hinder their ability to understand and apply health information. This study explored how stress and other variables impact parent health literacy during hospitalization.

Methods: A cross-sectional design included a demographic survey, the Perceived Stress Scale (PSS-10), and the Newest Vital Sign (NVS). Bivariate analyses (Chi-square, t-tests) and logistic regression were used to assess …