Nursing Commons^™

Staff Education To Improve Knowledge On Early Recognition Of Staff Burnout In Nurses Working In Long-Term Care, Geraldine Ndeng Akonwah

Walden Dissertations and Doctoral Studies

This doctoral project was a practice-based staff education project aimed at educating nurses concerning early burnout recognition. The educational intervention was chosen to promote awareness and knowledge related to the concept of burnout and self-care among nurses employed in a long-term care facility. The practice problem addressed was the high prevalence of nurse burnout and the limited ability of nurses to recognize early signs of burnout. The problem is significant in nursing practice as burnout is detrimental to the clinical judgment, patient safety, job satisfaction and staff retention. The guiding question of the project was as follows: Does a staff …

Emergency Nurses’ Perspectives On Workload, Stress, And Violence In The Context Of The U.S. Nursing Shortage, Wanda Marie Haynes

Walden Dissertations and Doctoral Studies

The nursing shortage is a critical global issue that significantly impacts emergency nurses (ER), leading to increased workloads, psychological stress, and heightened exposure to workplace violence (WPV). This phenomenon raises concerns among healthcare administrators and nurse leaders who seek strategies to improve retention and ensure quality patient care. The purpose of this qualitative study was to explore the meaning of workload, stress, and WPV among ER nurses during the U.S. nursing shortage. Guided by Herzberg’s two-factor theory, the study employed a phenomenological approach to capture nurses’ lived experiences. Data were collected through semi-structured interviews with eight ER nurses from diverse …

Sexual And Gender Minority Nurses’ Minority Stress In The Workplace: A Scoping Review, Justin Chavis, Robin Dawson Phd, Rn, Cpnp-Pc, Faan, Liam C. Hein

Faculty Publications

Background

Purpose

Methods

Staff Education To Improve Rn Accountability In Interdisciplinary Rounds Using Qr Code Tracking, Jennifer L. Zimmerman

Walden Dissertations and Doctoral Studies

Interdisciplinary rounding is essential for effective communication, coordinated care, and patient‑centered decision‑making; however, baseline observational audits on pediatric inpatient units at a large northeastern hospital revealed that nurses were present for only 54% of rounding opportunities, with no formal accountability process. This Doctor of Nursing Practice project aimed to improve registered nurse (RN) engagement and accountability in interdisciplinary rounds through a structured staff education intervention paired with a QR code–based tracking process. The practice‑focused question examined whether educating nursing staff on a QR code rounding system would increase nurses’ knowledge of rounding expectations and positively influence accountability behaviors. Fourteen RNs …

Immediate Skin-To-Skin Contact At Very Preterm Birth And Effect On Infant Socio-Emotional Stress Response And Mother–Infant Cortisol Co-Regulation: Secondary Outcomes From The Randomised Clinical Immediate Parent-Infant Skin-To-Skin Study (Ipistoss), Karoline Lode-Kolz, Siri Lillieskold, Hanne Brit Hetland, Eleonora Mascheroni, Stina Klemming, Hanne Pike, Agnes Linner, Nils J. Bergman, Bjorn Westrup, Ulrika Ådén, Evalotte Morelius, Rosario Montirosso, Wibke Jonas, Siren Rettedal

Research outputs 2022 to 2026

Objective To explore the effects of immediate parent–infant skin-to-skin contact (iSSC) at very preterm birth on maternal–infant behavioural responses and hypothalamic–pituitary–adrenal (HPA) axis reactivity to age-appropriate socio-emotional stress at 4months corrected age. Design Two secondary outcomes from a multicentre randomised controlled trial with two non-blinded parallel groups. Setting Three Scandinavian neonatal intensive care units, level 2 and level 3. Participants 91 infants born at gestational age 28+0to 32+6 from April 2018 to June 2021. Singletons and twins with a second caregiver present were included, regardless of mode of birth. Higher-order births, infants with congenital infections and major malformations were excluded. …

Prevalence Of Premenstrual Syndrome, Premenstrual Dysphoric Disorder, And Dysmenorrhea In Nursing Students: A Systematic Review, Meta-Analysis, And Evidence-Based Recommendations, Sabyasachi Maity, Bharathi Gadad, Hansapani Rodrigo, Seham Noorani, Ayesha Usman, Chloe Lark, Mona Attarpour, Ivy Mageto, Lucas Schwartz, Nikhilesh Anand

School of Medicine Publications

Introduction: Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or …

Program Proposal For A Nurse Led Pre-Procedure Readiness Program, Walter Magramo

Walden Dissertations and Doctoral Studies

Same-day outpatient procedural cancellations represent a persistent challenge for healthcare organizations, negatively affecting patient safety, access, operational efficiency, and financial performance. This Doctor of Nursing Practice (DNP) executive leadership project proposes the implementation of a nurse-led, artificial intelligence (AI)–enhanced preprocedural readiness program within an outpatient procedural department. The initiative integrates standardized nurse-led readiness checklists, AI-supported clinical decision support embedded in the electronic health record, structured nurse-led outreach, and standardized patient and staff education to proactively identify and address preventable barriers to procedural readiness. Internal organizational data identified a sustained same-day cancellation rate of approximately 22%, with most cancellations attributable to …

Mitigating Throughput Delays, Sherry Cabebe-Jacolbia

Walden Dissertations and Doctoral Studies

Throughput widely affects all healthcare organizations. The patient care quality gap centers on throughput because poor flow and boarding causes overcrowding, leading to adverse outcomes and mortality. The practice-focused question was: How can the hospital throughput be improved to help prevent adverse effects when boarding in the emergency room (ER) for a long period of time? This process improvement project was implemented by multidisciplinary teams who addressed barriers in patient flow in real-time. The implementation stage showed boarding time in August of 2025 of 4,275 minutes to October 2025 of 2,545 minutes. The throughput performance trending scorecard of the metrics …

Nurse-Led Telehealth Quality Improvement Initiative For Chronic Disease Management In Rural North Dakota, Alona J. Jarmin

Walden Dissertations and Doctoral Studies

In this quality improvement project, I assessed a telehealth-enhanced care coordination model in a rural primary care clinic to improve chronic disease management for adults with limited access to in-person services. The issues addressed included delayed follow-up, inconsistent self-management support, and limited continuity of care, which significantly affect rural populations and health equity. The purpose of this doctoral project was to evaluate whether a structured telehealth follow-up protocol improved key care coordination outcomes, appointment adherence, follow-up timeliness, and documentation completeness for rural adults receiving chronic disease management services. In this project, I employed a pre-/postimplementation evaluation design using de-identified electronic …

Staff Education On Motivational Interviewing And Culturally Responsive Education To Reduce No-Shows And Appointment Cancellations, Aisha Adigun

Walden Dissertations and Doctoral Studies

No-show and late appointment cancellations remain significant challenges in outpatient psychiatry clinics, negatively impacting continuity of care, clinic efficiency, and patient outcomes. Motivational interviewing (MI) and culturally responsive communication are evidence-based approaches that support patient engagement and understanding, yet they are not consistently incorporated into staff education related to appointment adherence. This project evaluates whether staff education on MI and culturally responsive communication increases staff knowledge and skills in educating patients about no-show and appointment cancellation policies and whether this education contributes to improved appointment attendance. A pre–post intervention design will be used in an outpatient psychiatry clinic. Clinical and …

Multimodal Interventions To Assist In Reducing No Show Rates In An Outpatient Primary Care Setting, Amelia Barber

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) incorporated a Clinical Practice Guideline (CPG) approach to address a practice issue of increased no show rates of patients scheduled for follow-up appointments in an adult outpatient primary care setting. Missed appointments symbolize a long-standing practice problem in ambulatory care, exacerbating challenges like healthcare expenses, fragmented care, inefficient resource utilization, and delayed treatment often resulting in negative patient outcomes. The project’s purpose was to develop an evidence-based CPG with integrated multimodal patient outreach strategies, including patient portal, text messaging, transportation support, and live reminder calls within Electronic Health Record (EHR) system to prevent and/or …

Development Of A Comfort Care Clinical Practice Guideline And Standardized Comfort Care Kits In Adult Home Hospice, Kelly Miller

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project focused on the development and expert appraisal of a clinical practice guideline (CPG) to improve home-based comfort care in hospice settings. Terminally ill patients frequently experience distressing symptoms such as pain, dyspnea, and nausea, yet inconsistent symptom management and documentation practices persist across hospice care (Henson et al., 2020). A CPG was developed to evaluate a comfort care kit for patients. The CPG was independently reviewed by a three-member expert panel using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, which consists of 23 items that are organized into …

Staff Education To Enhance Self-Care Support For Nurses, Charisma Olive

Walden Dissertations and Doctoral Studies

Background: High stress and burnout among maternity unit nurses negatively impact both nurse well-being and patient care quality. Research indicates that nurse burnout is associated with impaired cognitive function, reduced emotional connection with patients, and suboptimal job performance, all of which directly impact patient safety. Purpose: The purpose of this quality improvement project was to implement a comprehensive staff education program teaching evidence-based self-care strategies while assessing organizational support systems for nurse wellness. Methods: This three-phase quality improvement project utilized Lewin’s change management model combined with the ADDIE instructional design framework. Phase I (baseline assessment) involved 17 participating maternity nurses …

Staff Education To Address Financial Barriers In Outpatient Psychiatric Care, Yvette Taffou Kamayou

Walden Dissertations and Doctoral Studies

This staff education project addressed financial barriers that prevent psychiatric outpatients from accessing consistent care. High no-show rates in outpatient psychiatry, often 20–40%, stem largely from costs such as co-pays, transportation, and medication, leading to missed appointments, poorer outcomes, and increased healthcare costs. The practice-focused question was “In an outpatient psychiatric clinic, does a targeted staff education program on non-judgmental financial discussions, sliding-scale fees, and telehealth options improve staff knowledge, confidence, and patient referral rates to resources over 8 weeks?” The purpose was to implement and evaluate a structured educational intervention to equip staff with tools for addressing financial barriers, …

Staff Education On Integrating Holistic And Herbal Therapies For Adults With Depression, Kettelene P. Mcmorris

Walden Dissertations and Doctoral Studies

Adults with depression frequently use or inquire about holistic and herbal therapies; however, inconsistent and non-standardized staff education regarding the safe, evidence-based integration of these therapies may contribute to variable counseling practices and potential patient safety risks. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a structured staff education intervention focused on integrating holistic and herbal therapies for adults with depression in an outpatient behavioral health practice. The practice-focused question examined whether staff education would improve staff knowledge related to commonly used holistic and herbal therapies and associated safety considerations. A …

Staff Education Of Fall Prevention Intervention In The Emergency Department, Jonathan Jaramillo

Walden Dissertations and Doctoral Studies

Patient falls remain a significant patient safety concern in emergency departments (EDs) despite the routine use of fall risk screening tools. At the project site, continued fall events suggested a gap in staff knowledge, confidence, and consistent application of evidence-based fall prevention strategies. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether a targeted staff education intervention would improve ED nursing staff's knowledge, confidence, and intent to identify fall risk, implement prevention strategies, and respond appropriately to patient falls. Guided by the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) instructional design model, an evidence-based educational intervention was developed …

Staff Education To Enhance Phq-9 Depression Screening In A Mental Health Clinic, Constance Gawum Chingo

Walden Dissertations and Doctoral Studies

Doctor of Nursing Practice Project Summary Lack of standardization in the implementation and documentation of the Patient Health Questionnaire-9 (PHQ-9) was noted in this outpatient mental health clinic, impeding reproducible depression screening and evidence-based monitoring. The purpose of this Doctor of Nursing Practice (DNP) project was to examine whether staff education, enhanced by clinical workflow aids, could foster uniform PHQ-9 documentation in applicable patient encounters. Strategies employed included a systematic staff education session, a quick reference guide, an electronic health record (EHR) guide, and provision of prompt guidance and support during adoption. A pre- and post-quality improvement assessment was conducted …

Optimizing Telehealth Staff Education To Improve Medication Adherence In Adults With Ptsd, Omotayo Abdul

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education quality improvement initiative designed to optimize telehealth training for nurses to improve medication adherence in adults with posttraumatic stress disorder (PTSD). Telehealth has become an essential modality for delivering mental health care, yet its effectiveness depends heavily on nurses’ ability to communicate effectively, build trust, and engage patients in treatment discussions. Medication nonadherence remains a significant challenge in PTSD care and is closely linked to the quality of clinician communication and patient engagement during care encounters. The practice-focused question guiding this project asked how a staff education project on PTSD …

Staff Education Project Educational Intervention To Improve Oral Health Referrals., Ruby Latosha Mccain

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project is a staff education initiative designed to evaluate the impact of an educational intervention on primary care staff's knowledge and confidence in recognizing oral health red flags that warrant dental referral. A pre and posttest design was used to assess changes in knowledge and self-reported confidence following the intervention. Oral health is a vital yet often under-addressed component of primary care. Patients with early oral disease usually present in primary care settings. Still, these conditions may go unrecognized due to the limited oral health training among clinic staff. Addressing this gap is critical to …

The Importance Of Timely Documentation Of Updates On Patients’ Records In Improving Documentation Accuracy And Reducing Clinical Errors At The Home Health Agency, Sandra Aigbekaen

Walden Dissertations and Doctoral Studies

Timely and accurate documentation is essential to patient safety, care coordination, and risk reduction in home health care. In this Doctor of Nursing Practice project, I implemented an evidence-based educational intervention to improve documentation practices among clinicians at a pediatric home health agency in the southwest United States. Guided by the analyze, design, develop, implement, and evaluate (ADDIE) instructional design model, I conducted the project to evaluate whether focused education would improve documentation accuracy, consistency, and timeliness. A targeted literature review on electronic health record (EHR) best practices, structured documentation, and patient safety informed the development of five training modules …

Developing A Comprehensive Program Plan For Postpartum Mental Health Assessment And Follow-Up Care, Kimberly Osborne

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was an executive leadership proposal to develop an evidence-based program plan for standardized postpartum mental health screening and structured referral processes within an obstetric clinic. The practice problem was inconsistent postpartum mental health screening and follow up. Internal organizational data demonstrated elevated no-show and cancellation rates among obstetric patients referred for mental health services, reflecting gaps in care coordination, particularly for rural and underserved populations. The purpose of this project was to develop a comprehensive program plan guided by the following practice-focused question: Will a standardized postpartum mental health screening and structured referral program …

Development Of An Evidence-Based Educational Intervention Designed To Increase Staff Knowledge And Competence In Comprehensive Fall-Prevention Practices, Jacqueline U. Becerra

Walden Dissertations and Doctoral Studies

Inpatient falls continue to represent a significant nurse-sensitive quality indicator associated with patient injury, extended hospital stays, and increased healthcare costs. Despite the presence of established fall-prevention protocols, inconsistent completion of fall-risk assessments and uneven application of prevention strategies contributed to ongoing fall events at the project site. The practice problem addressed in this Doctor of Nursing Practice (DNP) project was the lack of consistent staff knowledge and application of evidence-based fall-prevention practices. The purpose of this evidence-based quality improvement project was to implement and evaluate a structured fall-prevention staff education program to increase inpatient staff knowledge related to fall-prevention …

Silence Is Golden: Quiet Hours Vs. Delirium In The Picu, Chastity Gillmore-Williams, Kevin Lai, North Porter, Jade Orozco, Corrie Zuker, Bria Pierce

2025

No abstract provided.

Staff Education To Improve Consistent Utilization Of The Phq-9 Depression Screening Tool, Ekaette Akpabio

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed the inconsistent use of standardized depression screening tools in an outpatient behavioral health setting. The purpose of the project was to implement a structured staff education intervention to improve clinician knowledge, confidence, and consistency in PHQ-9 documentation. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved delivering targeted education to behavioral health clinicians and evaluating practice implications. Findings support that staff education promotes improved documentation practices, supports accurate symptom assessment, and enhances patient safety. Incorporating standardized screening education into onboarding and ongoing professional development may contribute to sustainable, evidence-based mental …

Staff Education To Medical Surgical Nurses On Structured Discharge Checklist, Johnmary Odinigwe

Walden Dissertations and Doctoral Studies

Inconsistent discharge practices among medical-surgical nurses contribute to communication gaps, patient confusion, and preventable adverse outcomes following hospital discharge. Nurses, as frontline providers of discharge education, play a critical role in ensuring safe and effective transitions of care. This Doctor of Nursing Practice (DNP) project addressed a practice gap in nurses’ knowledge of implementing a structured discharge checklist. The purpose of this staff education project was to evaluate whether a structured discharge checklist education program would improve medical-surgical nurses’ knowledge of standardized discharge education practices. A pretest–posttest design was used to assess changes in knowledge among 36 medical-surgical nurses. Participants …

Shaping Tiny Futures: Exploring Plagiocephaly Prevention In A Level Iv Nicu, Alejandra Lozano, Mia Charles, Mimi Ngo

2025

No abstract provided.

Increasing Knowledge And Awareness In Mental Health Assessments Among Nurses, Valerie Jiles-Brown

Walden Dissertations and Doctoral Studies

Mental health conditions affect 59 million individuals annually in the United States, translating to one in every four adults. Given this, mental health has emerged as a critical component of an individual’s overall health and well-being, with nurses being pivotal in identifying and addressing mental health concerns. However, research indicates that nurses often lack the knowledge and awareness to conduct mental health assessments. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an educational intervention focused on mental health assessments increased knowledge and awareness among nurses working in a local organization. A total of …

Resilience Education To Increase Staff Knowledge Regarding Stress Management, Patricia Ngozi Egwu

Walden Dissertations and Doctoral Studies

This doctoral project implemented a staff education program to promote nursing knowledge of resilience training and stress management at an outpatient mental health clinic. Workplace stress contributes to medication errors and to poor Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Nurse Communication scores, both of which undermine patient safety. The practice-based question was: Does resilience education enhance stress management strategy knowledge from pre- to post-education? The purpose was to evaluate whether structured resilience education improved nursing knowledge of stress management, guided by the analysis, design, development, implementation, and evaluation (ADDIE) model. Using the Johns Hopkins evidence-based practice (JHEBP) …

A Quality Improvement Staff Education To Reduce Mental Health Stigma Among Healthcare Professionals, Chinwe Anthonia Chukwumerije

Walden Dissertations and Doctoral Studies

Mental health stigma among healthcare professionals remains a barrier to help-seeking behaviors, workforce well-being, and psychological safety. This Doctor of Nursing Practice project addressed a practice gap by providing standardized, evidence-based staff education to reduce mental health stigma. The practice-focused question examined whether implementing an evidence-based staff education guideline improved healthcare professionals’ knowledge, attitudes, and confidence regarding mental health stigma. An evidence-based educational intervention was developed using the ADDIE instructional design model and informed by an integrative literature review. The intervention was delivered through structured staff education sessions and evaluated using pre- and post-intervention design. Results demonstrated improved knowledge of …

Staff Education Project Staff Education To Increase Knowledge Of The Patient Health Questionnaire-9 Screening Tool, Linda Ejem

Walden Dissertations and Doctoral Studies

This staff education doctoral project focused on educating nursing staff about the Patient Health Questionnaire-9 (PHQ-9) for depression screening in inpatient psychiatric care. Addressing this issue is crucial, as poor adherence leads to missed diagnoses and treatment, increased hospital visits, and poor patient outcomes. Low adherence to the PHQ-9 depression screening protocol has emerged as a significant practice gap. The purpose of this doctoral project was to increase nursing staff knowledge of the PHQ-9 depression screening tool in psychiatric care through staff education. The practice-focused question was: Does education on PHQ-9 depression symptoms improve nursing staff knowledge as compared pre- …