Nursing Commons^™

Improving Patient Satisfaction With Discharge And Recovery Preparedness, Leanne N. Davis

Doctoral Dissertations and Projects

The Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS-CAHPS) survey is a standardized tool healthcare organizations utilize to measure patient perceptions of care. The survey results are linked to reimbursement by many insurers, making it prudent for health systems to work toward increasing patient satisfaction with their care. This evidence-based practice project followed the Iowa Model of Evidence-Based Practice to implement a quasi-experimental pilot that would determine whether providing written and verbal patient discharge education in both the preoperative phase of care and the postoperative phase of care compared to only the postoperative phase of care …

Improving Patients' Confidence In Self-Care Management And Preventing Hospital Readmission Within 30 Days Of Discharge In The Heart Failure Population, Kelly Carroll

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Heart failure (HF) is a chronic, progressive condition and a leading cause of hospital admissions nationwide. The 30-day readmission rate for HF patients is approximately 23.4%, contributing to increased morbidity, mortality, and significant healthcare costs. Each HF-related readmission is estimated to result in a financial loss of $15,789 per patient due to reduced reimbursement from both private and public insurers. This underscores the critical need for timely follow-up care, particularly within the first 30 days post-discharge.Without adequate follow-up and patient education, many individuals lack the confidence and knowledge necessary for safe and effective self-management in the outpatient setting, …

Policy Proposal For Integrating Pediatric Mental Health Into Nursing Practice In Uganda, Giselle S. Perez

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Mental health disorders affect over 1 in 7 individuals aged 10 to 19 globally. In low- and middle-income countries like Uganda, limited access to mental health specialists and pervasive stigma exacerbate the gap in care. Nurses, often the first point of contact, typically lack adequate pediatric mental health training. The proposal aims to address this gap by equipping nurses with the knowledge and competencies to identify, intervene, and support children with mental health disorders. Purpose: This proposal advocates for implementing targeted, continuing education in pediatric mental health for Ugandan nurses. The goal is to enhance the quality of …

Beyond The Bmi: An Educational, Family-Centered Approach To Identifying Risk For Childhood Obesity, Michelle J. Mak

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, the increasing prevalence of obesity has caused public health concerns. From 2017 to 2020, 14.7 million children ages 2 to 19 were considered obese. The main parameter for diagnosis is a body mass index (BMI) at or above the 95th percentile on the growth chart. Additionally, overweight is defined as a BMI between the 85th and 95th percentiles. At a pediatric primary care clinic in San Diego, CA, over a third of patients are considered overweight or obese. Obesity comorbidities can include type 2 diabetes, hypertension, and hyperlipidemia. Overweight adolescents have a 70% likelihood of …

From Fee For Service To Outcome Based Care: A Policy Proposal To Reduce Provider Burnout In Assertive Community Treatment, Amanda M. Thompson

Doctor of Nursing Practice Final Manuscripts

Purpose: This project examines the impact of the fee-for-service (FFS) reimbursement models on provider burnout within Assertive Community Treatment (ACT) programs and proposes a hybrid reimbursement framework that integrates case-rate and outcome-based payment structures. The goal is to enhance care quality, improve provider retention and optimize patient outcomes by addressing financial and administrative inefficiencies inherent in the current model.

Background: Mental illness affects over 59 million U.S. adults with serious mental illness (SMI) presenting significant challenges in healthcare delivery. ACT is an evidence-based, multidisciplinary approach designed to provide intensive, community-based psychiatric care to individuals with serious mental illness (SMI). However, …

Staff Education On Gad-7 Screening Tool Implementation, Sandra Oghomwen Osemwonta

Walden Dissertations and Doctoral Studies

As a staff educational project, I addressed a critical issue in nursing practice. In many clinical settings, medical personnel are unprepared to use screening instruments such as the Generalized Anxiety Disorder 7-Item (GAD-7) tool because they do not possess the requisite expertise, which often leads to missed or delayed identification of anxiety symptoms. Timely and accurate mental health assessments are essential for effective patient care and improved clinical outcomes. Does an educational program of a Psychiatric outpatient clinic increase staff knowledge and confidence in using the General Anxiety Disorder (GAD-7) tool, compared to baseline knowledge before training? was the central …

Increasing Advance Directive Completion: A Future Initiative For All, Hilda A. Lince

Doctor of Nursing Practice Final Manuscripts

Abstract

Problem Statement: Healthcare providers focus on delivering quality and patient-centered care. Yet, without any direction, healthcare providers treat patients as a full code until someone can speak on the patient’s behalf. Therefore, it is crucial that patients make their wishes known.

Description of Innovation: On a cardiac step-down unit, registered nurses were educated on the PREPARE advance directive. Upon admission to the unit, patients were asked if they had an advance directive. If the patient did not have an advance directive, they were educated on the importance of having an advance directive. Then they were given the PREPARE …

Staff Education On Importance Of Medication Adherence For Patients Living With Schizophrenia, Sonia Obehi Okojie

Walden Dissertations and Doctoral Studies

This DNP project aimed to address the lack of staff knowledge regarding medication adherence in patients with schizophrenia to better support these patients and to address a critical organizational knowledge gap. Schizophrenia is a chronic illness that impacts quality of life and medication noncompliance, often causing relapses and hospitalization. Evidence has shown that medication compliance improves symptoms, reduces hospital visits, and leads to better overall disease outcomes. A review on the project site indicated a wide knowledge deficit for the staff on interventions to enhance compliance to medication regimens by schizophrenia patients. It is an important issue to address in …

Mental Health And The Role Of Social Support In The Lives Of Vulnerabilized Sexual Minority Women, Jennifer L. Glick, Megan G. Nguyen, Aimee K. Huang, Kamila A. Alexander, Danielle German

School of Public Health Faculty Publications

Introduction Sexual minority women (SMW; women who self-identify as lesbian, queer, etc., as well as heterosexually-identified women who experience attraction to romantic or sexual partnerships with women) and vulnerabilized women (those marginalized due to structural forces such as housing insecurity, violence, sex exchange, drug use, or HIV positive status) experience a range of mental health challenges compared to their heterosexual and general population counterparts. General populations studies show a positive relationship between social support and mental health; less is known about SMW experiencing intersecting multi-layered vulnerabilities. This study characterizes mental health stressors, identifies social support sources and forms, and explores …

Staff Education On Documentation For Hospice Registered Nurses, Sharon Spencer Cunningham

Walden Dissertations and Doctoral Studies

Summary Documentation is a part of a daily task that all nurses undertake. Its purpose is to provide validation of care rendered to patients. In the hospice setting, nurses’ documentation is crucial, as it supports whether a patient qualifies to receive hospice services. If proper documentation is not recorded, patients can lose services and organizations can face a loss of revenue and potential fines. At a hospice organization in the Southeast United States, there was little emphasis of the importance of documentation that adheres to guidelines set by Centers for Medicare and Medicaid Services (CMS). Therefore, nurses’ documentation lacked the …

Increasing Depression Risk Screening In Hospice And Palliative Care Patients, Elizabeth Kanini Michaels

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education project. The practice problem involved inconsistent depression risk screening in hospice and palliative care patients. It was crucial to address this, as depression can be pervasive in this population. The practice-focused question was, For registered nurses who work in a palliative or hospice care unit, does education on depression risk screening increase depression screening rates as compared 12 weeks before to 12 after the education? The project aimed to improve depression risk screening rates through staff education. The Johns Hopkins nursing evidence-based practice model was used to assess 13 supporting articles …

Prearrival Phone Call Initiative To Decrease Procedural Cancellations And Delays, Fazali Nkoloma

Walden Dissertations and Doctoral Studies

This doctor of nursing practice project evaluation of an organizational quality improvement initiative focused on evaluating the effectiveness of implementing a prearrival phone call process for interventional radiology patients scheduled for procedures requiring moderate sedation or anesthesia. Adherence to NPO guidelines is crucial for patient safety before moderate sedation and anesthesia. The practice problem identified was the number of procedures that were canceled or delayed because of patient nonadherence with NPO guidelines. The practice-focused question that guided this project was, Can the implementation of prearrival phone calls in the preprocedural radiology surgical services help improve patient adherence with NPO protocol …

Staff Education To Improve Patient Outcomes And Treatment Compliance Through Use Of Motivational Interviewing In The Mental Health Setting, Rachel Nardi

Walden Dissertations and Doctoral Studies

Summary: Treatment noncompliance is a significant problem within the realm of mental health care. Recurrent noncompliance increases symptom severity, the likelihood of a crisis, and the burden placed on mental health care resources. Motivational interviewing (MI) is an evidence-based practice (EBP) demonstrated through extensive research to positively affect patient outcomes. Teaching MI to mental health care providers is one option organizational leaders can choose to address treatment noncompliance. In order for MI to become standard nursing practice, a method of education must be developed and implemented. This necessitates the identification of effective education delivery methods. A staff education project was …

Staff Educational Program On The Patient Health Questionnaire-9 Depression Screening Tool In A Psychiatric Outpatient Clinic, Chinwe Genevive Nwaigwe

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project focused on improving the knowledge and confidence of psychiatric outpatient clinic staff in administering and interpreting the Patient Health Questionnaire-9 (PHQ-9), a critical tool for depression screening. Given the high prevalence of depression and disparities in mental health care, inconsistent PHQ-9 use can lead to delayed diagnoses and unequal access to treatment. Addressing this gap is both a clinical priority and a matter of social justice. I delivered a 2-hour educational program for 17 staff members to improve screening practices. The session included a PowerPoint presentation, role playing, and an interactive …

Clinical Practice Guideline For Wound Care Management In Primary Healthcare Settings Across The British Virgin Islands To Minimize Clinical Practice Variations, Trorisia Shanika John

Walden Dissertations and Doctoral Studies

This quality improvement (QI) initiative in a British Virgin Islands (BVI) primary healthcare setting involved the problem of inconsistent wound care management among registered nurses, which was a concern that was identified in a 2023 audit. The BVI Health Service Authority (HSA)’s diverse nursing staff, which is recruited across the Caribbean, contributed to varied wound care approaches, negatively impacting healthcare delivery and quality. These inconsistencies led to unequal resource access, increased infection and complication risks, and potential financial and legal liabilities. Furthermore, it could negatively affect staff and patient perceptions, potentially decreasing patient satisfaction, highlighting the urgent need for standardized …

Interprofessional Collaboration Between Primary Care And Occupational Therapy, Ellen Modlin, Phd, Otr/L, Bcp, Caps, Deana Shevit Goldin, Phd, Dnp, Arnp, Fnp-Bc

Journal of Interprofessional Practice and Collaboration

Purpose: This article explores the utilization of occupational therapy (OT) in interprofessional health care teams in adult populations. Primary care settings are typically the first point of contact for individuals seeking health care services; therefore, primary care practitioners (PCPs) are in a unique position to initiate collaboration with specialty clinicians to optimize the use of health care resources.

Method: Peer- reviewed literature from primary care and OT research was reviewed and summarized. The search focused on barriers and potential opportunities for collaboration between primary care and occupational therapy in adult populations.

Results: Occupational therapy (OT) is underutilized, as lack of …

The Role Of Social Media In Higher Education For Recruitment And Retention And The Implications For Nursing Programs, Cari Granier, Jamie Gravois

Journal of Interprofessional Practice and Collaboration

Abstract:

Purpose: This review article assesses findings related to social media use in regards to student recruitment and retention for higher education institutions (HEIs) including schools of nursing. This review outlines the need for building a social media presence, creating engaging content for target audiences, available platforms, and posting times and frequency. Methods: A literature review was conducted with keywords including the following terms in combination with “social media and” higher education marketing, higher education recruitment, university marketing, university recruitment, college marketing, and college recruitment. Results: College applicants rely on social media when making decisions about …

Optimizing Warfarin Management In Cardiovascular Care, Tessa A. Martinez

Doctor of Nursing Practice Final Manuscripts

Background: Maintaining a therapeutic International Normalized Ratio (INR) is essential to reduce bleeding and thromboembolic risks in patients on warfarin therapy. In a rural outpatient cardiac clinic serving a predominantly underserved population, many patients face financial and access barriers that preclude the use of newer non-vitamin K antagonist oral anticoagulants (NOACs). Patients with atrial fibrillation (AF) or mechanical valve replacements who rely on warfarin require consistent monitoring and management, which can be challenging in settings with limited resources and staffing.

Purpose: The purpose of this evidence-based pilot project was to improve therapeutic INR outcomes through the implementation of a standardized …

Improving Access And Retention Of Medication-Assisted Treatment (Mat) For Minority Inmates In The California State Prison System: A Quality Improvement Initiative Using A Culturally Competent Approach, Douglas Seangmany

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The opioid crisis disproportionately affects minority populations in correctional settings, where limited access to Medication-Assisted Treatment (MAT) contributes to high overdose rates and healthcare costs. At a California prison, only 48% of individuals with Opioid Use Disorder (OUD) receive MAT. Local Problem: Limited MAT access and low provider cultural competence exacerbate health disparities among minority inmates. Methods: A culturally sensitive training intervention was implemented for healthcare providers at a California prison, guided by a review of ten evidence-based studies. Pre- and post-training surveys on a 5-point Likert scale assessed provider competency, defined as "Agree" or …

Staff Education Program On Smoking Cessation Strategies, Justina Ugorji

Walden Dissertations and Doctoral Studies

This doctoral project implemented a staff education program to enhance smoking cessation knowledge in a mental-health care setting. Despite the well-documented risks, smoking cessation efforts remain insufficient, often due to providers’ limited knowledge and confidence in delivering effective interventions. The practice-focused question for this project was: Will implementing a staff education program improve health care providers’ knowledge of smoking cessation strategies as compared pre- to posteducation? The purpose was to equip providers with evidence-based techniques to enhance patient smoking cessation. A comprehensive literature review using the Johns Hopkins evidence-based practice model was performed, and 20 relevant articles were identified supporting …

Staff Education To Improve Staff Knowledge Of Medication Adherence Strategies For Mood Disorders, Samnang Son Oeur

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Staff Education to Improve Staff Knowledge of Medication Adherence Strategies for Mood Disorders by Samnang Oeur MS, University of California, San Francisco, 2019 BS, University of Massachusetts, Lowell, 2009 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2025

Staff Education To Improve Oncology Nurses' Cultural Competency Literacy, Sharon Taziwa

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Staff Education to Improve Oncology Nurses' Cultural Competency Literacy by Sharon Taziwa MSN, Walden University, 2023 BSN, University of Texas at Arlington, 2015 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2025 Summary A staff education project was implemented at a comprehensive cancer center in the Southwest United States. The nurses at the comprehensive cancer center faced challenges in delivering culturally competent care to a diverse patient population, necessitating enhanced training in cultural knowledge, skills, and awareness. The lack of consistent cultural competence …

Staff Education On Psychoeducational Interventions For Older Patients With Mood Disorder, Vera Ngenwie Nkweti

Walden Dissertations and Doctoral Studies

No included because we used the Walden University School Template

Educational Program Focused On Medication-Assisted Treatment To Improve Healthcare Providers’ Knowledge Of Managing Opioid Use Disorder In Primary Care Setting, Genean Marie Doyle

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project is a staff education project focused on enhancing healthcare providers’ knowledge of managing opioid use disorder (OUD) through medication-assisted treatment (MAT) in a primary care setting. The practice problem focuses on the lack of provider knowledge and persistent misconceptions about MAT. Primary care providers often feel ill-equipped to manage OUD, due to inadequate formal training and report insufficient understanding of MAT medications, regulatory requirements, and patient management strategies, contributing to underutilization of MAT, even in settings where patient need is high. Given the ongoing opioid epidemic and the important role that primary care …

The Implementation Of A Blended Learning Course To Enhance Leadership And Management Capabilities In Liberian Student Nurse Anesthetists, Donnell Carter

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Leadership plays a crucial role in the functioning of a health system, particularly in resource-constrained settings like Liberia. Effective leadership is essential for identifying solutions and leading teams towards achieving important objectives. Improving leadership competencies among emerging Liberian nurse anesthetists is key to enhancing anesthesiaoutcomes in Liberia. The delivery of high-quality, safe anesthesia in Liberia is contingent on this.

METHODS: This quality improvement project (QI) implemented a transnational blended learning leadership andmanagement course to increase the knowledge, skills, and confidence of Liberian student nurse anesthetists. We used quantitative methods to organize and describe selected outcomes. We also used qualitative …

Implementation Of A Nurse Practitioner-Led Video Telehealth Program To Improve Triage For Pediatric Patients In An Ambulatory Intestinal Rehabilitation Center, Elizabeth Castle

Doctor of Nursing Practice Scholarly Projects

Background: Children with short bowel syndrome are medically complex, requiring specialized management and coordinated care to address acute triage issues between scheduled visits. Their risk for rapid decompensation and distance from specialty centers often necessitates telephone-based triage—a typically non-reimbursable method. At a leading Northeastern U.S. children’s hospital, the Intestinal Rehabilitation (IR) center manages high-risk telephone triage of these patients’ concerns using experienced nurse practitioners. The inability to directly visualize patients during telephone encounters, however, limits clinical assessment and decision-making, presenting challenges to efficient and safe care delivery. A systematic literature review indicated that telehealth can enhance parental confidence, improve clinician …

Sexy In Scrubs: How The Media And Cultural Perception Of Nurses Leads To Sexual Harassment And Violence In The Workplace, Elizabeth S. Stehle

Honors Projects

Western media has perpetuated society’s perspective of the nursing role through a sexual lens rather than a professional. Nurses face high levels of sexual harassment and violence, with some studies showing up to 80% of nurses experiencing some form of sexual harassment in the workplace at some point in their career. The relationship between the media’s sexualization of nurses has led to an increase in harassment and violence in the profession, as well as proliferating the stereotype of ‘sexy nurses.’ In this literature review, I examine both the media and cultural perception of the nurse and the data surrounding sexual …

A Novel Approach To Competency-Based Education For Pediatric Nurse Practitioners: Bringing Clarity To Competencies, Kristina L. Banks, Carol L. Savrin

Faculty Scholarship

Introduction: Guidance for Pediatric Nurse Practitioner (PNP) competency-based education (CBE) is provided by the National Organization of Nurse Practitioner Faculties (NONPF) and the American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Nursing Education (“Essentials”). The 2021 AACN Essentials update prompted a significant shift from traditional to (CBE)for Nurse Practitioner (NP) faculty. NONPF has responded, updating its NP Role Core Competencies and domains to be congruent with the AACN 2021 Essentials, but NONPF's population-specific competencies remain unchanged since 2013. Methods: Two PNP faculty conducted a multistep crosswalk between the NONPF 2013 population-based competencies for Primary and …

Gothic Gender And Colonized Women: A Gothic Feminist Reading Of Women As The Subaltern In Evelina And Northanger Abbey, Abigail Chandler

Seton Hall University Dissertations and Theses (ETDs)

Evelina by Frances Burney and Northanger Abbey by Jane Austen are two woman-authored, Gothic texts that explore themes of feminism and coming of age as subaltern in a patriarchal context. The main character in each must enter the world and become disillusioned to the reality that they are treated as subhuman because they are women. The term subaltern refers to those living in the margins and their suppressed “potential for life and creativity, in given historical circumstances” (Pandey 4735), and primarily focuses on ethnic or racial oppression in postcolonial settings; however, this thesis explores the idea of women in patriarchal …

Barriers To Breastfeeding In The Workplace As A Nurse And Perceived Support, Juliette Parker

Honors College Theses

This paper explores a literature review of how women are expanding more into the workforce requiring them to balance the demands of both family and work. Attention was given to the importance of breastfeeding, and the current research involving lactation support for working lactating nurses. The goal of this paper was to assess a Southeast Georgia hospital for the barriers and perceived support for working lactating nurses. Based on the available literature investigating this topic, it was hypothesized that nurses would report a lack of resources and support for working lactating mothers. To investigate this, an anonymous survey was conducted …