Nursing Commons^™

Decreasing The Incidence Of Healthcare Associated Presure Injuries In The Acute Care Setting, Amanda R. Nichols

Doctoral Dissertations and Projects

Healthcare-associated pressure injuries (HAPIs) can cause great harm to vulnerable patients. Acquiring a HAPI during hospitalization can result in delayed wound treatment, prolonged hospitalization, risk for infection, reimbursement issues for the facility, and delayed patient discharge. Avoiding these injuries is essential to improve patient outcomes. Research reveals that the implementation of nurse education and two registered nurse skin assessments on admission, instead of one nurse skin assessment, can decrease the incidence of healthcare-associated pressure injuries. Using the Iowa model, the goal of this scholarly project is to implement evidence-based research to change the current process and decrease the incidence of …

Evaluating Mental Health Providers’ Knowledge And Attitudes Towards Stigma Among Teenagers Aged 13 To 19 Years With Mental Illness, Fredrica Murray-Johnson

Doctoral Dissertations and Projects

Limited knowledge and poor attitudes among mental health providers contribute to stigma towards individuals with mental illness, adversely affecting treatment experience and outcomes. This study evaluated the effectiveness of an educational intervention in improving mental health providers’ knowledge and attitudes toward stigma-based practices. The clinical question stated: Among mental health providers, does an educational intervention, compared to standard practice, improve knowledge and attitudes of stigma and promote evidence-based care delivery to teenagers aged 13 to 19 with mental illness within six weeks? The Iowa Model of Evidence-Based Practice (EBP) was used as a framework for implementing this study. The quasi-experimental …

Passing The Torch: Evaluating Documentation Quality And Its Impact On Nurses’ Perceptions Of Communication Across Va Care Transitions, Shannon Collier Baker

Doctoral Dissertations and Projects

Effective communication during transitions of care is crucial to ensuring patient safety and optimizing outcomes. However, current practices may fall short in supporting clear and comprehensive communication among healthcare providers, particularly during complex care transitions involving Veterans who have received targeted care coordination intervention outside of their primary Patient Aligned Care Team. The absence of standardized tools for handoff documentation exacerbates fragmented communication and ambiguity about the transfer of care management responsibilities, potentially leading to avoidable errors and care coordination failures. This project aimed to investigate nurses' perceptions of the adequacy of communication during the transition of moderate to complex …

Increasing Patient Satisfaction And Engagement By Improving Patient Intake Process In An Outpatient Mental Health Clinic, Hotenesia Njoroge

Doctoral Dissertations and Projects

This scholarly project aimed to enhance patient satisfaction and engagement by improving the intake process in an outpatient mental health clinic. Inefficient intake procedures, characterized by long wait times, communication gaps, and misreferrals, contribute to patient disengagement and dissatisfaction. A quasi-experimental pretest-posttest design evaluated a patient-centered intervention involving communication training, streamlined workflows, and real-time updates. Data were collected from 52 participants using Patient-Reported Experience Measures (PREMs) and qualitative feedback. Quantitative results revealed high satisfaction with staff respect (M = 4.19), communication clarity (M = 4.06), and facility comfort (M = 4.13). Wait time satisfaction scored slightly lower (M = 3.96), …

Self-Efficacy And Burnout Of Nursing Faculty: The Mediating Role Of Fear Of Negative Evaluation, Sarah Murray Kelly

Doctoral Dissertations and Projects

The contents of this manuscript include a dissertation of a survey research study using the theoretical models of self-efficacy and burnout. The quantitative study used mediation analysis to explore the relationship between self-efficacy and burnout, with fear of negative evaluation as a mediator. Fear of negative evaluation was measured using the Brief Fear of Negative Evaluation Scale-Revised; self-efficacy was calculated using the General Self-Efficacy Scale; and burnout was measured using the Oldenburg Burnout Inventory. The study drew a sample of 98 academic nurse educators (N = 98) who were evaluated by student evaluations of teaching. The sample included educators who …

Enhancing Parental Knowledge Of Functional Medicine Interventions For Adhd: An Educational Initiative To Improve Caregiver Competency, Julie Gammer

Doctoral Dissertations and Projects

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent pediatric psychiatric condition often managed with stimulant medications that carry potential side effects and may not address underlying causes. Research findings indicate a significant gap in caregiver knowledge and confidence in treating their child's ADHD with functional medicine strategies. This project develops an evidence-based educational initiative designed to enhance caregiver knowledge and confidence in applying functional medicine interventions—such as dietary modifications, targeted supplementation, and gut health restoration—as natural, root-cause approaches to managing ADHD symptoms. The project utilized a 30-minute audiovisual presentation and was evaluated using pre- and post-intervention competency tests, as well as a …

Experiences Of First-Generation Nursing Students After Their First Year At An Hbcu: A Transcendental Phenomenological Study, Ari L. Cuffee

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore the lived experiences of first-generation nursing students (FGNS) after their first year at a Historically Black College or University (HBCU). The central research question asked, “What are the lived experiences of first-generation nursing students who have completed one year at a Historically Black University?” The theoretical framework that guided this study was Banks’ theory of multicultural education. This theory demonstrated how educators taught FGNS using the multicultural education paradigm with strategies and procedures to make provisions for culturally, racially, and ethnically diverse students. Data were analyzed using Moustakas’ interpretive phenomenological …

Student Nurse-Led Hypertension Management In A Rural Free Clinic, Leslie Okhirkhian

Cardiovascular Research Symposium

This pilot project seeks to evaluate the effect of nurse-led assessments and education on blood pressure control among adult patients with prehypertension and hypertension who attend a free health clinic located inside of a rural community in Southeastern Virginia. A leading, modifiable risk factor for cardiovascular disease is hypertension, yet disparities in consistent healthcare access and education disproportionately affect rural populations. Nurse-led interventions are a promising strategy for improving hypertension control through personalized education, blood pressure monitoring, and follow-up.

Methods: Participants with a diagnosis of prehypertension or hypertension were recruited from a free rural health clinic (n=20). Over a 7-week …

Blood Culture Contamination Rates, Jackqueline R. Easley

Walden Dissertations and Doctoral Studies

The timely and accurate collection of blood culture specimens is essential for improving patient outcomes and minimizing complications. Contaminated specimens can lead to unnecessary antibiotic use, prolonged hospital stays, and delays in appropriate treatment. At one eastern healthcare facility, monthly blood culture contamination rates reached an average of 4.5%, prompting the need for a targeted intervention. The objective of this project was to determine whether a structured process and trained team could reduce contamination rates to below 1%. De-identified data were reviewed using descriptive statistics to observe contamination trends over time, by department, and by month. Using the t-test, contamination …

Staff Education On Perinatal Opioid Use Disorder, Mukisha Livingston Gunter

Walden Dissertations and Doctoral Studies

Perinatal Opioid Use Disorder (POUD) constitutes a significant public health issue with important ramifications for both mothers and their newborns. The gap in practice identified for this Doctor of Nursing Practice staff education project was the perinatal nurses’ lack of knowledge regarding POUD. The problem was the need for POUD education for the nurses. The practice focus questions were: Will there be a change in knowledge by perinatal nurses following the delivery of the education as shown by a pretest/posttest? Will the participants evaluate the education as having met the program objectives related to the curriculum presented? Guided by the …

It’S Yappy Hour! Standardized Rounding That Keeps Patient Families In The Loop, Brittany Culp, Audrey Hinchey, Bronwen Seidel, Michelle Aboagye, Dileen Bilbas, Cheyanne Dias

2024

No abstract provided.

Staff Education On Discharge Planning For A County Crisis Stabilization Unit, Eric Rowshaun Luster

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education initiative developed to address insufficient staff knowledge related to discharge planning for homeless individuals experiencing mental health crises. The purpose of the project was to examine whether enhanced staff training could improve knowledge of transitional care planning, thereby supporting equitable, safe, and inclusive discharge processes. By improving staff proficiency, the project sought to reduce gaps in care coordination and promote continuity of treatment for a highly vulnerable patient population. The project was implemented at a Crisis Stabilization Unit (CSU) in the southern United States that serves individuals experiencing homelessness, …

Staff Education Project For Enhancing Medication Adherence In Mental Health: An Evidence-Based Education Program For Healthcare Practitioners In Outpatient Clinics, Rita Erina Pyuzza

Walden Dissertations and Doctoral Studies

The staff education project was designed to address medication non-adherence among mental health patients in an outpatient psychiatric clinic by enhancing the knowledge and skills of mental health nurses and nurse practitioners. The lack of structured, evidence-based training on medication adherence strategies has contributed to poor patient outcomes, increased hospitalizations, and higher healthcare costs. Clinic patient reports indicated 50% medication non-adherence, highlighting the need to address non-adherence through effective nursing-led education, medication management, and adherence monitoring. The project assessed whether enhancing the outpatient healthcare providers’ skills and knowledge through a structured, evidence-based program would improve the providers’ medication adherence strategies. …

Bridging The Gap: Strategies To Minimize Medication Delays And Enhance Interdisciplinary Collaboration In Hospital Settings, James Greenalch, Hector Murillo, Nantz Shelby Olson, Emma Putnam, Heidi Rodriguez, Jenna Stehly

2024

No abstract provided.

Bridging The Gap: A Cross-Unit Approach To Thermoregulation In A Large Pediatric Hospital, Isabelle Hernandez, Hernandez Velasco, Samuel Casu, Angel Castillo, Loree Sword, Noe Garcia

2024

No abstract provided.

Staff Education To Enhance Nursing Knowledge And Confidence In Withdrawal Management Using The Clinical Institute Withdrawal Assessment And Clinical Opiate Withdrawal Scale, Margaret Sarana Hector

Walden Dissertations and Doctoral Studies

This quality improvement staff education project addressed the inconsistent use of the Clinical Institute Withdrawal Assessment (CIWA) and Clinical Opiate Withdrawal Scale (COWS) assessment tools among nursing staff in an adult psychiatric and addictions unit located in the Mid-Atlantic region of the United States. Inconsistent use of the CIWA and COWS tools may lead to unfavorable patient outcomes. The goal of this project was to enhance nursing familiarity, confidence, and sense of importance in using CIWA and COWS tools for assessing and managing withdrawal symptoms in patients with co-occurring depression and substance use disorders. A pre- and posteducation survey design …

An Education Project For Training Nurses On Self-Care Strategies To Prevent Work-Related Burnout, Nsemboowo Effiong Enyong

Walden Dissertations and Doctoral Studies

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Staff Education To Improve Mental Health Knowledge Among Critical Care Staff, Ashton Barnes

Walden Dissertations and Doctoral Studies

Mental health literacy is increasingly recognized as a critical component of nursing practice, particularly in high-acuity environments. At a local healthcare organization, leadership identified a gap in staff education related to mental health, contributing to elevated incidences of anxiety, depression, posttraumatic stress disorder (PTSD), burnout, and diminished patient outcomes. In response, I conducted this Doctor of Nursing Practice project to evaluate whether a structured educational intervention could enhance mental health knowledge and competency among critical care staff. Participants completed pre- and postintervention assessments to evaluate core concepts in mental health awareness and clinical application, with supplementary qualitative feedback gathered to …

Medication Safety: A Policy Journey To Reduce Medication Errors, Elia M. Campos, Kathleen Klimpel, Joseph Burkhard

Doctor of Nursing Practice Final Manuscripts

Abstract

Medication Safety: A Policy Journey to Reduce Medication Errors

Background: Medication errors have long been a significant concern. Unsafe medication practices and errors can pose serious risks of injury and preventable harm within healthcare systems.

These errors can lead to severe consequences and have the potential to result in injury, disability, or even death. The World Health Organization highlights that in the United States, an estimated 1.3 million people experience medication-related harm, with 7,000-9,000 people dying due to a medication error each year (WHO, 2023). On average, one adverse drug effect (ADE) adds more than $2,000 to the cost …

Socio-Cultural Correlates Of Breastfeeding Behavior Among Latina Mothers And Its Implications For Child Health, Liliana Davalos, Brisa Rodriguez Alcantar, Marissa Martinez, Christopher Johansen

Social and Behavioral Health Faculty Research

Background: Latina mothers in the United States report lower rates of breastfeeding initiation and exclusivity than their non-Hispanic counterparts. Lower rates of breastfeeding in infancy may lead to a higher rate of excess weight in childhood and adverse health conditions. Breastfeeding disparities in Latina women have been previously correlated with socio-cultural factors such as acculturation, education, income, nativity, and marital status. This study examines whether socio-cultural factors are associated with breastfeeding behaviors in Latina mothers in Nevada. Methods: Participants were Latina mothers [n = 214] over 18 years of age, with a child 2–5 years old. A logistic regression was …

Leveraging Artificial Intelligence (Ai) For Competency-Based Course Design: A Quality Improvement Project In Nursing Education, Lesslie Bull

Doctor of Nursing Practice Projects

This quality improvement project addressed inefficient, manual course design processes contributing to faculty workload and declining National Council Licensure Examination (NCLEX) pass rates at a rural Texas university’s baccalaureate nursing program. Guided by the Roy Adaptation Model and the Plan-Do-Study-Act framework, the project evaluated the effect of integrating artificial intelligence (AI) tools on faculty perceptions of technology adoption, specifically perceived usefulness (PU), perceived ease of use (PEOU), and behavioral intention (BI). Using a quasi-experimental pre-/post-intervention design, twelve faculty members completed a one-hour, evidence-based training using the Generative AI for Instructional Development and Education (GAIDE) framework, and eight faculty participated in …

Transforming Fall Prevention Using A Systems-Wide Approach, Jessica Pierce

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project proposal targets fall reduction and injury prevention in a Veteran Affairs Medical Center (VAMC). The initiative implements a non-restrictive, evidence-based fall prevention program that excludes side rails and bed alarms, emphasizing systematic patient safety and personalized care. Falls are a major safety concern at the VAMC due to ineffective traditional methods, inconsistent assessments, and reliance on restraints, contributing to high fall rates and increased healthcare costs. The project successfully achieved consensus from an interprofessional team on developing a comprehensive fall reduction program. Evidence indicates that removing restrictive devices enhances staff engagement and protocol …

An Anesthesia Informed Consent Checklist And Ahrq Share Decision-Making Model For Labor And Delivery Patients: A Quality Improvement Project, Katherine C. Burnett

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and Significance: Informed consent is the disclosure of all benefits, risks, and alternatives to patients for a given intervention. Recalling all important details during the consenting process can prove difficult for providers. The process is further complicated for obstetric patients since healthcare decisions also have consequences for the fetus. The American College of Obstetricians and Gynecologists’ Committee (ACOGC) (2021) recommends shared decision-making models (SDMs) for the obstetric patient population. SDMs engage patients in healthcare decisions by reaching a decision through provider expertise, best evidence, and patient values. In addition, surgical informed consent checklists have emerged as useful …

Staff Education Focused On Screening Patients For Depression Using The Phq-9 Tool, Eveline Mankom Gwaabe

Walden Dissertations and Doctoral Studies

The doctor of nursing practice (DNP) project at a community health center (CHC) addressed a performance improvement measure related to the usability of the depression screening tool, Patient Health Questionnaire (PHQ-9), for patients 12 years and older. At CHC, the mental health providers underutilized this tool, leading to missed opportunities in identifying patients 12 years and older with depressive disorders. These missed opportunities may contribute to suboptimal patient treatment outcomes. The purpose of the staff educational program was to increase CHC staffs’ understanding of the PHQ-9 screening tool for routine depression screening. Ten mental health providers participated in the program, …

Staff Education To Nursing Leadership On Implementation Requirements Of A Nurse Residency Program, Sherri Ulfig

Walden Dissertations and Doctoral Studies

Nurse residency programs provide new graduate nurses with a solid foundation to support their transition into practice. The DNP students completed a staff education project to educate nurse leaders on the implementation requirements of a nurse residency program at a not-for-profit hospital in the Midwest. The identified practice problem was that the organization paused its nurse residency program during the COVID-19 pandemic due to critical staffing needs, and the leaders wanted to redesign the program to meet current practice standards. The educational project question addressed whether education for site leaders would increase their knowledge of the implementation requirements of a …

Staff Education Project To Train Charge Nurses On The Use Of The Tsam Framework To Improve Leadership Competencies, Natoya Gaye Langley

Walden Dissertations and Doctoral Studies

The purpose of this doctoral project was to improve charge nurse leadership competencies through education on the tiered skills acquisition model (TSAM), addressing challenges of high turnover, limited orientation, and compromised care quality in an inpatient psychiatric facility. The background reveals a two-year financial loss of over $1.8 million tied to staff attrition, highlighting the urgent need for a structured training framework. TSAM, a progressive, competency-based model, offers a pathway for deliberate skill acquisition, leadership growth, and enhanced role clarity. A staff education program was implemented with ten charge nurses, incorporating a pretest, PowerPoint training, scenario-based roleplays, and a posttest. …

Staff Education On Using The Epworth Sleepiness Scale In Primary Care, Amanda Robyn Jones

Walden Dissertations and Doctoral Studies

Sleep disorders are prevalent in primary care settings and often remain underdiagnosed due to inconsistent assessment practices. This doctoral project was conducted to develop, implement, and evaluate whether an educational intervention for registered nurses would enhance their knowledge on using the Epworth Sleepiness Scale (ESS) for sleep assessment in primary care. Guided by adult learning theories and the analysis, design, development, implementation, and evaluation instructional design model, the aim of the project was to address the practice gap related to inadequate sleep evaluations, ultimately improving patient outcomes and promoting holistic care. Evidence was collected through pre and post intervention assessments, …

Enhancing Interprofessional Competence Among Speech Pathology, Nursing, Social Work, And Psychology Students Using Simulated Case Presentations, Elizabeth Oommen, Emily Helder, Kayla Johnson, Stacia L. Hoeksema, Laura Schipper

University Faculty Publications and Creative Works

Background: This study assesses the impact of an Interprofessional Education (IPE) program (which included simulated case presentations), on the perceived competence and quality of interprofessional (IP) work products of undergraduate social work, nursing, psychology students, and graduate students in speech-language pathology.

Methods: Participants included 123 students who participated in IP colloquiums through reviewing clinical cases, developing IP assessment and treatment goals, and presenting these to fellow students and faculty. Pre- and post-testing using IPEC Competency Self-Assessment Tool was used for assessment. For each colloquium, the students from all disciplines also submitted a single worksheet for their assigned case, …

Relationship Of Provider-Patient Communication And Health Literacy To Self-Management In Black Adults With Type-2 Diabetes, Linda Walker

Walden Dissertations and Doctoral Studies

Black adults in the United States are nearly twice as likely to receive a diagnosis of type 2 diabetes mellitus (T2DM) and are more susceptible to severe diabetes-related complications. Health literacy and patient-provider communication (PPC) are extremely important for self-management in patients of all ethnicities however, 58% of non-Hispanic Blacks have basic or below-basic health literacy skills compared to 28% of non-Hispanic Whites. The purpose of this descriptive correlational study, with was guided by the interaction model of client behavior, was to determine (a) if there is relationship between PPC during the healthcare encounter to health literacy among Black adults …

Optimizing Workflow And Patient Outcomes: The Impact Of The Modified Adult Difficult Intravenous Access (A-Diva) Scale On Peripheral Iv Access: A Quality Improvement Project, Dakota S. Weaver, Ryan O'Sullivan

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Peripheral intravenous cannulation (PIVC) is one of the most performed invasive procedures in hospital settings, yet it is frequently associated with multiple attempts in patients with difficult intravenous access (DIVA). In obstetric (OB) triage settings, where time-sensitive care is critical, failed PIVC attempts can delay treatment and negatively affect patient experience. The Modified Adult Difficult Intravenous Access (A-DIVA) scale is a validated tool designed to identify patients at risk for DIVA and guide early use of advanced techniques such as ultrasound (US) guidance.

A QI initiative was implemented in the OB triage unit of a large academic hospital. The tool …