Nursing Commons^™

Staff Education To Enhance Psychiatric Medication Adherence In Psychiatric Care, Emmanuel Nusta

Walden Dissertations and Doctoral Studies

Medication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play …

Staff Education To Emergency Nurses On Improving Handoff Communication Using The I-Pass Tool, Lekeyna Gleason

Walden Dissertations and Doctoral Studies

Effective communication during nurse-to-nurse handoff remains a critical determinant of patient safety in high-acuity emergency settings, where rapid decisions and fluctuating clinical demands can lead to inconsistent structure, omission of critical information, and inefficient transitions of care. The practice gap identified was a lack of standardized knowledge and consistent use of a structured bedside handoff tool among emergency department (ED) nurses. The practice-focused question guiding this project was, Does educating ED nurses on using the I-PASS bedside handoff tool improve knowledge of structured bedside reporting as measured by pre- and post-implementation surveys? The ADDIE framework and the Johns Hopkins evidence-based …

Staff Education For The Management Of Chronic Pain In Patients With Mental Health Disorders, Jude Osagie Ukpebor

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a practice-focused quality improvement staff education initiative designed to address a gap in nurses’ knowledge related to chronic pain management in patients with mental health disorders. Chronic pain frequently coexists with psychiatric conditions, yet nurses often lack formal education on biopsychosocial, trauma-informed, and non-pharmacologic pain management approaches, contributing to fragmented and inequitable care. Addressing this gap is essential to improving patient outcomes and advancing evidence-based nursing practice. The practice-focused question asked whether implementing a targeted nurse education program would improve nurses’ knowledge related to chronic pain management in patients with mental health disorders. …

Bringing The Heat: Optimizing Current Feed Warming Practices For Hospitalized Infants, Kaitlyn Ballard, Christine Nguyen, Madison Pavelka, David Rice, Yesica Rivas, Hannah Gabrielle Sellers, Nathan Xie

2025

No abstract provided.

Executive Leadership System Improvement Mobile Lung Cancer Screening, Tracy Holladay

Walden Dissertations and Doctoral Studies

This doctoral project is an evidence‑based practice initiative to develop a mobile lung cancer screening program that expands early detection services in rural Arkansas. The practice problem involves low screening rates, high mortality, and access barriers that delay diagnosis for high‑risk individuals, making this work essential to nursing roles in prevention, coordination, education, and population health. The practice focused question examined whether creating a Mobile Lung Cancer Screening Unit proposal will support timely referrals and treatment. The purpose of the project was to design a feasible, evidence informed model aligned with organizational capacity and equitable access goals. Analytical strategies included …

Self-Stigma Of Seeking Help, Psychological Safety, And Employee Assistance Program Use In Nurses, Latisha Lenee Marshall

Walden Dissertations and Doctoral Studies

Employee assistance programs (EAPs) remain underutilized across various U.S. work sectors, including nursing. There are several barriers that impede nurses from using EAP services, including self-stigma of seeking help (SSOSH) and psychological safety (PS). The purposes of this study, which used the health promotion model as its theoretical framework, were to determine (a) if there was a difference in the level of SSOSH in nurses who have used EAPs and those who have not used EAPs, (b) if there was a difference in the level of PS in nurses who have used EAPs and nurses who have not used EAPs, …

Exploring The Relationship Among Nurse-Specific Factors And Triage Accuracy In The Emergency Setting, Krisada Suamchaiyaphum

ETDs from 2020-2029

Triage is a critical function of emergency nursing practice, directly influencing patient safety, flow, and outcomes in the emergency department (ED). Despite widespread use of standardized triage training and resources, triage accuracy among ED nurses remains suboptimal. The purpose of this three-manuscript dissertation was to examine factors associated with triage accuracy in the ED setting. Manuscript One was an integrative literature review of 14 studies published between 2011 and 2021, with reported triage accuracy rates ranging from 59.3% to 82%. Primary factors associated with triage accuracy were: nurse-specific, patient, and work environment factors. Manuscript Two reported a retrospective study of …

Bridging The Gap Transition From Pediatric Care To Adult Care, Jordan Garcia, Haley Henry, Amina Jamma, Guiliana Jimenez Carrion, Alexis Lowary, Jenna Potts, Josie Ramirez, Iman Siraj

2025

No abstract provided.

Staff Education To Increase Knowledge And Awareness Of Cultural Sensitivity Among Providers, Stephanie Chiamaka Anyanwu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project aimed to enhance cultural sensitivity among healthcare providers through an educational intervention in a local organization. With the U.S. foreign-born population exceeding 47 million, the need for culturally competent care has become paramount. The study involved nine participants who underwent a pretest and posttest assessment to evaluate their knowledge and awareness of cultural sensitivity. Results indicated a significant increase in knowledge, with pretest and posttest scores improving from a mean of 4.33 to 8.56 (p < 0.01). Awareness in key areas such as patient-provider relationships, cultural beliefs, and language barriers also showed marked improvement. These findings further support the necessity of ongoing cultural sensitivity training to enhance patient care and outcomes, highlighting the potential for broader application across healthcare institutions.

Staff Education On Metabolic Syndrome Screening In Patients Receiving Long-Acting Injectable Psychotropics, Efetze Metangpa Akana

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was a staff education initiative designed to improve metabolic syndrome screening practices for patients receiving long-acting injectable psychotropic medications in an outpatient psychiatric setting. People living with serious mental illness face a heightened risk of cardiometabolic conditions, and inconsistent screening leads to delayed detection, avoidable illness, and ongoing health disparities, underscoring the importance of this practice gap within nursing practice due to nurses’ central role in medication oversight and preventive care. A key limitation of the project was the small sample size and short-term evaluation period, which limited generalizability and did not allow …

Implementation Of Structured Nursing Leadership Rounding To Improve Hospital Policy Adherence, Irma Rose Maize

Walden Dissertations and Doctoral Studies

Variability in nursing policy compliance contributes to inconsistent clinical practice and compromises the delivery of standardized care. Limited leadership presence, support, and accountability have been identified as significant contributors to this practice gap. This Doctor of Nursing Practice project focused on educating nurse leaders about the importance and benefits of consistent unit-based leadership rounding as a strategy to support frontline nurses and reinforce policy adherence. A structured leadership rounding checklist was developed to guide purposeful, consistent check-ins with nursing staff, facilitating real-time support and identification of barriers to practice. Implementation of the checklist promoted increased leadership accessibility, improved communication, and …

Beyond Standard Sizes: Tailoring Dressings For Pediatric Central Venous Catheters, Alexandra Chheng, Emily Peterson, Jennifer Govea, Jennifer Stedman, Tara Carter

2025

No abstract provided.

Virtual And Remote Cardiac Rehabilitation For Older Adults: Current Evidence And Implementation Strategies, Sarah E. Slone, Rita D'Aoust, Rhonda Smith Wright, Victoria A. Yandle, Kurt G. Barringhaus

Faculty Publications

Purpose of Review

To present and analyze recent developments in remote cardiac rehabilitation for older adults, review outcomes data regarding clinical effectiveness of these modalities, and discuss implementation strategies targeted at older adults.

Recent Findings

Data from recent studies enrolling older adults into remote cardiac rehabilitation programs have yielded mixed results with some showing encouraging improvements in functional capacity and quality of life comparable to those obtained with center-based rehabilitation programs. Studies that showed no improvement in outcomes identified decreased patient engagement as an important driver of results. This underscores the importance of adapting remote cardiac rehabilitation programs to the …

What Matters To Residential Long-Term Care Residents: Contextualizing Perceptions Of Person-Centered Care, Luis J. Cordero, Sarah Dys, Diana White

Institute on Aging Publications

This study combines the CRITIC and DEMATEL methods and introduces a new hybrid scenario analysis approach that identifies cross-scenario strategies. We use Taiwan's wind energy industry as a case study to validate the process. Although scenario analysis has been applied across various fields and organization types—including strategic planning, education, training, and recent environmental issues—scholars have highlighted problems such as the subjectivity of qualitative analysis and the lack of quantitative evidence. To address this, this study integrates scenario analysis with quantitative multi-criteria decision analysis to support decision makers in conducting scenario evaluations. We achieve this by applying a multi-criteria approach to …

Nature-Based Approaches To Dementia, Cognitive Impairment, And Caregiver Well-Being: A Scoping Review Of Gardening And Therapeutic Strategies, Mary Dioise Ramos, Marcy Purnell, Jolie Harris, Gloria Giarratano

School of Nursing Faculty Publications

Background: Dementia is a growing global health concern, with behavioral and psychological symptoms (BPSD) contributing significantly to diminished quality of life and caregiver burden. Non-pharmacological interventions, such as gardening and nature-based therapies, are increasingly recognized for their therapeutic potential. Objectives: This scoping review aimed to: (1) map existing evidence on gardening and garden-based interventions for individuals with dementia; (2) assess impacts on caregivers; (3) identify mechanisms of benefit; and (4) summarize effective design and implementation strategies. Methods: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five databases. Studies were screened using Covidence. Inclusion criteria …

Teaching Staff About Pressure Ulcers, Ann Maria Stewart

Walden Dissertations and Doctoral Studies

Pressure ulcers are local injuries to the skin and underlying tissue primarily caused by prolonged pressure, friction, or shear forces. These preventable complications are prevalent among immobile patients and can lead to poor patient outcomes and increased healthcare costs. Despite the availability of evidence-based prevention strategies, significant gaps in practice continue due to limited staff knowledge, ineffective communication systems, and inconsistent implementation of established guidelines. This Doctor of Nursing Practice (DNP) project focused on enhancing nursing staff knowledge through an evidence-based educational strategy designed to educate staff on strategies for preventing pressure ulcers. The education program included a PowerPoint presentation …

Polypharmacy In The Geriatric Population, Colleen Laflamme

Walden Dissertations and Doctoral Studies

The project entailed the development and review of a clinical practice guideline (CPG) for reducing polypharmacy in the geriatric patient population. Polypharmacy is associated with increased risk of adverse drug events (ADEs) such as drug-drug interactions, poor adherence to pharmacotherapy, and increased risk of falls. Additionally, polypharmacy tends to increase high hospitalization rates and emergency department (ED) visits. From a nursing practice perspective, polypharmacy worsens patient outcomes and increases nurses’ workload and healthcare costs for patients. The purpose of this project was to develop a CPG with evidence based recommendations on how to reduce polypharmacy among older adults. The practice-focused …

Staff Education To Address Workplace Violence Against Staff, Julie Ann Childers

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) project, the primary focus was on addressing knowledge of workplace bullying within the hospital setting. The project involved developing and implementing an educational program to raise awareness, prevent workplace bullying, and effectively respond to it among healthcare staff. Workplace bullying harms physical and emotional well-being, reduces productivity, increases absenteeism, and increases turnover. The practice-focused question was as follows: In a hospital setting, does implementing a workplace violence (WPV) prevention education program for healthcare workers lead to increased knowledge of WPV incidents, awareness, and management among staff? Using evidence-based strategies and resources, the DNP …

Need For A Psychiatric Facility To Develop A Clinical Practice Guideline On Self-Care To Give To Patients Upon Discharge, Judith Agwu

Walden Dissertations and Doctoral Studies

The project is a Doctor of Nursing Practice (DNP) clinical practice guideline (CPG) on the need for a psychiatric facility to develop a CPG on self-care to give to patients upon discharge. The practice problem was a healthcare facility did not have guidelines to educate patients on self-care upon discharge. Addressing the problem within nursing practice can promote self-care practices and improve overall health outcomes for patients with mental illnesses. The practice-focused question that guided this project was: will a CPG potentially increase self-care among discharged patients? The purpose of the study was to develop a CPG on self-care for …

Faculty Perceptions Of Student Use Of Critical Thinking And Clinical Judgment In Prelicensure Alternative Pediatric Clinical Education, Vanessa Lee Lugo

Walden Dissertations and Doctoral Studies

Both the changing healthcare environment and diverse pediatric care needs highlight the importance of exploring nontraditional clinical placements for entry-level pediatric nursing students to assess their critical thinking (CT) and clinical judgment (CJ). Many graduates are unprepared for pediatric care, creating safety risks and gaps in meeting children’s healthcare needs. The purpose of this study, guided by communities of practice theory, was to explore faculty experiences with and perceptions of CT and CJ use at alternative pediatric clinical sites for prelicensure undergraduate students in the Northeastern United States. Eleven nursing faculty with recent experience working in nontraditional pediatric sites and …

The Effects Of A Nurse-Led Peace Program On Perceived Peaceful End-Of-Life And Quality Of Life Among Head And Neck Cancer Patients Undergoing Concurrent Chemoradiation, Sirinya Pimvichai, Yaowarat Matchim, Tanadej Sinthusake, Kiratiya Wongkalasin

Journal of Health Research

Background: Evidence indicates that peaceful end-of-life care programs benefit terminally ill patients, with nurses playing a central role in program delivery. However, no structured end-of-life care programs currently exist for patients with head and neck cancer (HNC), who often experience profound physical and psychological distress. A nurse-led Peaceful End-of-Life Care (PEACE) program was therefore developed. This study aimed to evaluate the effects of the PEACE program on perceived peaceful end-of-life (PEOL) and quality of life (QoL) among HNC patients undergoing concurrent chemoradiotherapy (CCRT).

Methods: A quasi-experimental, two-group time-series design was conducted with 64 HNC patients recruited from oncology wards at …

Improving Alcoholism Treatment Through Adverse Childhood Events Score Education, Miranda Cobenais

Walden Dissertations and Doctoral Studies

Summary I conducted this Doctor of Nursing Practice (DNP) staff education project to improve knowledge and clinical practice among mental health professionals. The problem identified at the project site was the limited awareness and use of Adverse Childhood Events (ACE) assessments in treating alcoholism. The practice focused question for this project was: Will educating staff on how ACE scores can improve treatment of alcoholism increase staff knowledge regarding the importance of assessing ACE scores to decrease relapse rates? The purpose of this doctoral project was to evaluate if an educational intervention can enhance staff understanding of the connection between ACEs …

Fort William First Nation People’S Perceptions Of Receiving Nursing Care To Meet Their Wholistic Health Needs, Kara Morriseau

Walden Dissertations and Doctoral Studies

There was limited knowledge of First Nations people’s experiences receiving nursing care to meet their wholistic health needs in Northern Ontario. The purpose of this qualitative interpretive description study, grounded in the two-eyed seeing framework and the Indigenous wholistic theory, was to explore First Nations people’s descriptions of receiving nursing care to meet their wholistic health needs in Northern Ontario. The study took place in the community of Fort William First Nation, a First Nations community in Northern Ontario. With approval from the Chief and Council of Fort William First Nation, semistructured interviews were conducted in person and on Zoom …

“It Seems Like A Never-Ending Job”: Voices Of Female Caregivers Of Older Adults In The Rural Communities, Lalani Nasreen, Bhagyashree Katare, Evans Appiah Osei, Siqi Yang, Sampada Wagle, Julian L. Gallegos, Abidemi Mary Ajuwon

School of Nursing Faculty Publications

Background: Rural female caregivers of older adults face significant caregiving challenges that puts them at high risk for poor self-care and wellbeing. Limited studies have examined the self-care needs of caregivers from a gender equity and social perspective.

Objective: Our study aims to explore the self-care needs and preferences of rural female caregivers and underlying key processes contributing toward their health and well-being. Methods: A qualitative descriptive design was used for the study. A purposive sample of (n = 20) rural female caregivers was obtained. In-depth individual interviews were conducted for data collection. Each interview was about 45- 60 min …

Falls Prevention In A Psychiatric Setting, Albert Koroma

Walden Dissertations and Doctoral Studies

The project is a staff education initiative designed to improve the knowledge of psychiatric mental health clinicians regarding fall prevention. The gap in practice was the staff’s knowledge deficit in fall prevention. The staff’s knowledge deficits result in inconsistent prevention strategies. The practice-focused question guiding the project was: Among psychiatric mental health clinicians, does participation in an evidence-based fall prevention education program increase knowledge of fall prevention strategies as compared to pre- to post-education? The purpose of the project was to improve clinician knowledge of psychiatric-specific fall risks and evidence-based prevention strategies. The analytical strategies utilized in the project included …

The Relationship Between The Health Science Reasoning Test And Successful Completion Of An Associate Degree Nursing Program: A Retrospective Predictive Study, Joyce A.Ajkuce Kucerovy

Doctoral Dissertations and Projects

The purpose of this study was to retrospectively identify whether the addition of an entrance exam such as the Health Science Reasoning Test (HSRT) to the current admission criteria of an associate degree nursing (ADN) education program would aid in selecting students with the highest chance of successfully completing the program and entering the workforce. A nonexperimental, retrospective, quantitative, predictive correlational study design was used. A retrospective convenience sample of 320 first-year nursing students in an ADN education program was obtained. The G* power analysis showed a minimum sample size of 107 students was needed. Statistical analysis involved a multiple …

Treatment For Women With Mental Health Disorders Associated With Reproductive Health: An Opportunity For Interprofessional Collaboration, Ellen Modlin Phd, Otr/L, Bcp, Caps, Deana Goldin Phd, Dnp, Arnp, Fnp-Bc, Pmhnp-Bc

Journal of Interprofessional Practice and Collaboration

Abstract

Purpose: This article proposes an opportunity for interprofessional collaboration between mental health practitioners (MHPs) and occupational therapy practitioners (OTPs) for the treatment of women experiencing mental health disorders (MHDs) associated with reproductive health (RH) changes throughout the lifespan. This collaborative approach have the potential to optimize women’s health care and mitigate the risk of fragmented care, as these conditions are highly complex.

Method: Peer- reviewed literature from mental health and occupational therapy (OT) research was reviewed and summarized. The search focused on the barriers and potential opportunities for collaboration between MHPs and OTPs in women affected with MHDs associated …

Development Of An Educational Intervention To Enhance Nurses’ Knowledge And Intent To Implement Evidence-Based Diabetes Self-Management In Clinical Practice, Anne Marie Sieyou Ngouane

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was purposed with closing critical gaps in staff knowledge and adherence to diabetes self-management protocols in a busy primary care clinic. Rising readmission rates and uneven use of American Diabetes Association (ADA) standards signaled an urgent need for a structured approach to staff education. To address this, a one-hour interactive training session was created that blended teaching, evidence-based handouts, and a practical diabetes care checklist. Staff learning was measured through pretest and posttest, confidence and adherence used a 5-point Likert-scale survey, and 21day readmission data tracked patient outcomes. The project question asked if …

Enhancing Anxiety Identification In Adult Patients, Wonda Crump

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing (DNP) project, I focused on implementing a staff education program for anxiety screening at a health and wellness clinic. Mental health conditions, particularly anxiety disorders, are common in primary care settings. Research shows that anxiety affects millions of adults, yet many cases remain undiagnosed. The practice problem that I identified was that many patients with anxiety disorders were going undiagnosed during regular clinic visits. The clinic had no standard process for screening anxiety, and staff members had a knowledge deficit on the proper use of anxiety assessment tools. This gap in practice led to missed …

Impact Of Dialysis On Medication Pharmacokinetics, Rachel Marie Bounds

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education initiative to improve nurses’ knowledge and comfort with dialysis-specific medication management. The project addressed a practice gap in which nurses at the clinical site had limited knowledge of medication administration for patients with end-stage renal disease. These patients have altered pharmacokinetics and high medication burden, which increases the risk of adverse drug events. Inappropriate management of medications during dialysis can lead to hypotension, ineffective treatment, and glucose instability, making this a critical nursing practice issue. The project answered the practice-focused question of whether a structured educational intervention would improve nurses’ knowledge and comfort …