Nursing Commons^™

Improving Retention Of Newly Hired Nurses In Home Care, Chidi D. Ihezue

Walden Dissertations and Doctoral Studies

In the home care setting, there is an increasing need for home care services due to aging populations and the rising prevalence of chronic diseases, as well as a scarcity of qualified home care staff to meet the health needs of patients in this setting. A home care agency's onboarding program, particularly its capacity to deliver comprehensive orientation and robust mentoring for new nurses, plays a crucial role in supporting the retention of newly employed nursing staff within the home care environment. Research indicates that without ongoing support and close monitoring, newly hired nurses may disengage during the onboarding and …

Assessing The Role Of Social Media As A Complementary Source In Pharmacovigilance: Insights From Faers, X (Formerly Twitter), And Askapatient Data Across Multiple Drug Classes, Nwanneka Okere

Dissertations

Background: Adverse drug reactions (ADRs) pose significant public health challenges yet remain substantially underreported in traditional pharmacovigilance systems. Social media platforms and patient-reported outcome forums have emerged as potential complementary sources for capturing real-time patient experiences with medications, but their integration with established surveillance systems remains underexplored.

Purpose: This study examined ADR reporting patterns across FDA Adverse Event Reporting System (FAERS), X (formerly Twitter), and Askapatient to evaluate whether patient-generated digital data can complement traditional pharmacovigilance systems for enhanced drug safety monitoring.

Methods: An explanatory sequential mixed-methods design analyzed 107,753 reports representing 289,740 individual ADR occurrences for …

Improving Healthcare Providers’ Knowledge On Heart Failure Self-Care Management, Linda Nkeiruka Ukwu

Walden Dissertations and Doctoral Studies

N/A

Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addresses the pervasive health issue of burnout among healthcare providers, focusing on a community mental health clinic where internal data revealed high levels of staff turnover, absenteeism, medication errors, financial constraints, poor patient outcomes, and low staff satisfaction. Shortage of healthcare providers, exposure to patient trauma, high emotional demands, and administrative burdens are the systemic stressors of burnout at the project site mental health facility. These factors collectively underscored the need for a system-wide burnout reduction program to safeguard provider well-being and ensure the delivery of high-quality patient care and safety.

Stress First Aid Implementation To Address Stress Among Acute Care Nurses, Obioma Maryann Asiegbu

Walden Dissertations and Doctoral Studies

Acute care nurses face persistent occupational stress that contributes to burnout, anxiety, depression, and high turnover rates within healthcare systems. The Stress First Aid (SFA) framework offers a proactive, evidence-based approach to identifying and managing psychological distress among healthcare workers. The purpose of this Doctor of Nursing Practice project was to implement and evaluate the SFA program as a structured, early-intervention model to improve nurse well-being, retention, and patient care outcomes in an acute care setting. Guided by the Stress Continuum Model and organizational change theory, this project emphasized early recognition of stress, peer support mechanisms, and continuous outcome monitoring. …

Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay

Walden Dissertations and Doctoral Studies

Summary This DNP staff education project focused on improving staff knowledge on self-care management of hypertension. The overarching patient care problem at the project site was uncontrolled hypertension among adult patients with lack of staff knowledge and confidence in delivering related patient education. Addressing uncontrolled hypertension is vital within nursing practice due to its impact on public health and the opportunity for a nurse-led evidence-based intervention to improve patient outcomes. The practice-focused question for this project was: “In adults with uncontrolled hypertension, does staff education program on hypertension self-care management improve staff knowledge on how to educate patients on self-care …

Evaluating The Compliance Of A Patient-Centered Daily Care Plan In An Acute Care Setting, Abigale Tzu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement evaluation project addressed inconsistent use of the Patient-Centered Daily Care Plan at a local acute care hospital. The problem was a gap in compliance with California Title 22 requirements, creating risk for survey deficiencies and limiting interdisciplinary communication. The purpose of this project was to evaluate whether the revised daily care plan improved individualized documentation and organizational compliance. De-identified aggregate data from pre-implementation (August–October 2023) and post-implementation (June–August 2024) periods were analyzed descriptively. Results showed a meaningful improvement in checklist completion, with compliance increasing from 94.8% to 97.3%. These findings demonstrated stronger …

Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri

Walden Dissertations and Doctoral Studies

Universal staff training to increase the validity and reliability of adolescent mental health screening was implemented in this quality improvement (QI) initiative. Depression and anxiety disorders often emerge between ages 12 and 17, yet evidence-based screening measures such as the Patient Health Questionnaire (PHQ-9/PHQ-9M) and Generalized Anxiety Disorder (GAD-7) are underutilized due to provider knowledge gaps, workflow inefficiencies, and cultural barriers. Guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, the project evaluated whether structured staff education improved early identification and diagnosis of adolescent depression and anxiety compared to routine practice. In workshops, web-based learning modules, case simulations, and …

Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross

Walden Dissertations and Doctoral Studies

Summary This doctoral, practice-focused quality improvement project used a mixed-methods design to evaluate the usability, acceptability, and clinical integration of a nutrition screening tool in a mental health outpatient clinic. The project addresses a key practice gap, the lack of evaluation of the implementation of a systematic nutrition screening for individuals with severe mental illness (SMI), which contributes to worsening psychiatric symptoms and delayed recovery. Aligning with nursing’s holistic and patient-centered framework, the initiative aimed to strengthen interprofessional collaboration and preventive care. The guiding practice-focused questions addressed: How usable and acceptable is the clinical practice guideline (CPG) tool among clinic …

Executive Leadership System Improvement: System- Level Program To Improve Care For Type-Ii Diabetic Patients, Jane Chukwura

Walden Dissertations and Doctoral Studies

The DNP Scholarly Project presents the Diabetes Interprofessional Management Program, an organization-wide, logic-model–driven initiative to improve glycemic control, empower self-management, and advance health equity for adults with type II diabetes. The project leverages an interprofessional team, targeted training, culturally tailored education, health technology tools, and community partnerships to translate resources into team-based care, personalized plans, self-management support, and continuous education, with outputs including trained staff, engaged patients, and standardized care protocols. Short-term outcomes center on reduced mean HbA1c, more patients achieving HbA1c <7%, and widespread adoption of evidence-based pathways with standardized testing cadences. Long-term outcomes focus on fewer complications, higher patient satisfaction, and reduced disparities through the expansion of Diabetes Self-Management Education (DSME) and culturally appropriate resources, underpinned by robust data governance. The evaluation and implementation plan measures clinical outcomes, patient experience, and equity over 0–24 months, using formative metrics (workflow deployment, training, testing timeliness, DSME referrals, portal use) and summative metrics (HbA1c changes, HbA1c <7% at 12 months, hospitalizations, complications, knowledge and quality of life, equity indicators, and ROI). Governance features a Data Steering Subcommittee and quarterly dashboards. Deliverables include standardized protocols, DSME curricula, EHR workflows, training, and a scalable, sustainable model for broader deployment.

Executive Summary: Clinical Practice Guideline Guideline For Identifying Patients At Risk For Posttraumatic Stress Disorder (Ptsd), Doris Chinazo Dibia

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) project, I developed a clinical practice guideline to address the absence of a standardized process for identifying adult outpatients at risk for posttraumatic stress disorder (PTSD) in a community-based mental health clinic. Without such a process, delays in trauma-focused care and inconsistent referrals may occur. The evidence base supports the use of brief, validated screening tools, such as the Primary Care PTSD Screen for DSM-5, for accurate risk identification in routine practice. The practice-focused question that I used to guide this project was: Will an evidence-based guideline for PTSD risk identification be approved …

Staff Education To Improve Provider Knowledge On Antibiotic Prescribing, Jessica Nicole Jaimez

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice (DNP) staff education project addressed a gap in guideline-based antibiotic prescribing among advanced practice registered nurses (APRNs) in an urgent care setting. The practice problem identified at the local project site was inconsistent adherence to Centers of Disease Control and Prevention (CDC) outpatient stewardship expectations, resulting in unnecessary antibiotic use for viral conditions and contributing to antimicrobial resistance. The practice-focused question for this project was as follows: In urgent care APRNs, does implementing a staff education program on guideline-based antibiotic prescribing improve provider-reported knowledge on antibiotic prescribing use? The purpose of this doctoral project …

Depression Screening In Veterans And Active-Duty Service Members With Chronic Pain, Lynelle Marie Endsley

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project addressed the absence of evidence-based depression screening among military members and veterans with chronic pain. Contrary to national guidelines, no standardized depression screening process was in place. This gap in practice was attributed to inadequate staff knowledge and understanding in using such tools. The purpose of this project was to evaluate whether staff education on the Patient Health Questionnaire-9 (PHQ-9) improved knowledge and confidence, in evaluating for and identifying depression in a high-risk population. The practice-focused question asked: Will staff education on the importance and consistent use PHQ-9 increase knowledge and confidence in depression …

Personalized Resistance Exercise With Peer Support For Women With Pcos Using A Smart Home Video Device: Pilot Randomized Controlled Trial Guided By Self-Determination Theory, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Cynthia F. Corbett Phd, Rn, Faan, Kesheng Wang

Faculty Publications

Background

Women with polycystic ovary syndrome (PCOS) report exercise barriers as stigma-related stress, lack of peer support, and facility issues. “Resistance exercise (RE) with peer support and bands/ball and digitally-based supervision” (REPS w/BANDS) was designed to help mitigate exercise barriers. Underscored by self-determination theory (SDT), the 12-week intervention was remotely delivered via digital technology and inclusive of peer support.

Purpose

The purposes of this pilot randomized controlled trial (RCT) were to test the feasibility and acceptability of REPS w/BANDS and explore signals of within- and between-group differences on outcomes (e.g., depressive symptoms and fitness).

Methods

Participants (N = 25) …

Development And Implementation Of A Treatment History And Authorization Checklist To Improve Access To Spravato Therapy For Treatment-Resistant Depression, Margaret Mae Scott

Walden Dissertations and Doctoral Studies

Background: Treatment-resistant depression (TRD) presents a significant clinical and administrative challenge, delaying access to evidence-based therapies such as intranasal esketamine (Spravato). Inconsistent documentation and lack of standardized clinical pathways contribute to insurance authorization delays, exacerbating health inequities and care fragmentation. Purpose: This DNP project aimed to develop and implement a standardized Treatment History Checklist and Clinical Practice Guideline to streamline documentation, support timely insurance authorization, and promote equitable access to Spravato therapy for patients with TRD. Methods: Using a systems change framework, the project employed gap analysis, stakeholder engagement, and iterative validation to design tools aligned with payer requirements and …

Development Of An Evidence-Based Educational Intervention To Advance Nurse Knowledge In Comprehensive Care Of Patients With Congestive Heart Failure, Jessica Smith

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project was a staff education intervention to increase nursing staff knowledge. Congestive heart failure (CHF) remains one of the leading causes of hospitalizations and has the highest readmission rates within 30 days of a previous admission. Consistent evidence reveals improving nursing knowledge reduces complications, improves self-management support, lowers readmission rates in this particular patient population. The DNP project was developed as a staff education intervention and focused on 30 nurses working on a telemetry unit in an acute care hospital. The project question was whether an educational intervention would increase general nursing knowledge caring …

Structured Follow-Up After Outpatient Visits: A Clinical Practice Guideline, Jeanette Serrano

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to develop an evidence-based clinical practice guideline (CPG) to reduce missed follow-up appointments and improve care continuity in a family medicine outpatient clinic. Missed follow-ups, especially common in underserved populations, compromise safety, delay treatment, and increase costs. The purpose of this doctoral project was to develop and appraise a CPG that integrates evidence-based strategies to improve follow-up procedures, reduce missed appointments, and enhance patient safety and care continuity in an outpatient setting. This project addressed the practice-focused question: Will a CPG around structured follow-up for patient visits in an outpatient clinic …

Staff Education To Improve Medicare Lung Cancer Screening And Processes, Ashley Mccammon

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education initiative to address underutilization of low-dose computed tomography (LDCT) lung cancer screening among Medicare-eligible patients at the project site. Lung cancer is the leading cause of cancer death, and LDCT screening reduces mortality by up to 20%. Internal data from the project site revealed that only 20.13% of eligible patients completed screening, underscoring the need for structured staff education to improve knowledge and support early detection. The practice focused question asked: Will a staff education on Medicare LDCT screening and processes increase staff knowledge towards the ultimate goal of increasing LDCT screening rates? …

Development Of An Evidence-Based Clinical Practice Guideline For Discharging Patients With Substance Use Disorder (Sud) From Outpatient Treatment To Community Care, Emmanuel Onyeani

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a gap in practice in an outpatient treatment center for discharging patients with substance use disorder (SUD), addressing the need for follow-up care and relapse prevention due to the widespread impact of SUD. Clinical practice guidelines (CPG) help healthcare professionals make informed decisions for specific clinical situations. The guiding question asked whether an expert panel would evaluate and validate a CPG developed from current, evidence-based literature and recommendations with 70% agreement using the AGREE II tool. The CPG focused on continuity of care, access to resources, and relapse prevention strategies. Seven expert …

Enhancing Home Health Nursing Knowledge Through Targeted Education On Polypharmacy Risk Awareness In Older Adults, Chinyeaka Linda Ogbonna

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education initiative addressed the problem of polypharmacy, a common issue in home health care that increases the risk of drug interactions, side effects, and hospitalizations. Nurses and aides often provide daily care but may not recognize high-risk medications or warning symptoms. Addressing this gap was vital to nursing practice because staff are on the front line of patient monitoring and safety. The practice-focused question asked whether structured education for home health staff would improve knowledge of polypharmacy risks by 20%, increase recognition of high-risk medications by 75%, and result in at least 75% …

Executive Summary: Staff Education Project Staff Education To Close A Knowledge Gap Regarding Restraints, Aaron Ross Ledbetter

Walden Dissertations and Doctoral Studies

The purpose of this Executive Summary is to address a gap in knowledge that I attempted to close regarding restraint utilization. Restraints, both physical and chemical, have been prevalent over the past ten years and with their increased utilization during the pandemic which has continued post-pandemic. Nursing as a culture has become more reliant on restraints as it allows more time for nurses to provide care elsewhere. Both physical and psychological complications have been recognized during the utilization of physical restraints. Their prominence, although helpful with time constraints for nurses, have shown to negatively impact the patients who they are …

Planning For Prevention: Implementing Pressure Injury Bundles In Hospice Settings, Ellie M. Martin, Mckenzie Pool

Scholars Week

There is an increased prevalence of pressure-related injuries in the hospice setting. This can be due to age, diagnosis, comorbidities, inadequate nutrition or hydration, lack of mobility, or inadequate care due to lack of education. Prevention bundles and policies are at every facility, but are not as effective as needed. This looks at the theoretical framework and ways to prevent pressure injuries as effectively as possible. Pulling information from multiple other research studies to put the best care bundle together to decrease the amount of pressure injuries.

Improved Patient Outcomes With Continuous Video Monitoring, Ethan Morrison, Drake May, Jack L. Rideout

Scholars Week

Improved Patient Outcomes with Continuous Video Monitoring

Objective

The use of human sitters has been the normal policy in hospitals across the United States for years. Recently, there has been an introduction to remote video monitoring systems that are aimed at replacing the need for human sitters. Our goal is to change the policy of a local hospital in our area to adjust their stance on human sitters and implement remote video monitoring.

Methods/Results

Our method of accomplishing this involved a PowerPoint presentation and an evidence-based practice paper with three different scholarly research articles that have been peer-reviewed. We presented …

Antibiotic Stewardship And The Prevention Of Healthcare-Associated C.Diff, Nevaeh Tyson, Angel Pearson

Scholars Week

Healthcare-associated Clostridium difficile (C.difficile) infections remain a significant burden to many healthcare facilities across North America. This infection is often linked to long-term antibiotic use and ineffective infection control methods. This presentation addresses current evidence-based practice protocols on the prevention of C.difficile, emphasizing the need for increased monitoring of antibiotic therapy and improved infection control strategies.

Implementing Evidence-Based Cluster Care To Improve Preterm Infant Stability, Kendal B. Hargrove, Mattie C. Kent

Scholars Week

Premature infants in neonatal intensive care units (NICUs) are frequently exposed to excessive handling, light, and noise, which can disrupt sleep and hinder growth. This project investigates whether current caregiving schedules at Deaconess Henderson Hospital’s NICU support adequate rest and development in preterm neonates. Analysis revealed an absence of clear policies regarding clustered care, inconsistent implementation, and limited staff understanding of its evidence-based benefits. Guided by the Roy Adaptation Model, this project proposes the development and implementation of a standardized clustered care policy to promote neonatal adaptation and stability. Evidence from multiple studies (Wang et al., 2021; Hendy et al., …

The Importance Of Deep Vein Thrombosis Prophylaxis In Post-Surgical Patients, Abigail N. Nelson, Madison R. Holmen

Scholars Week

Deep vein thrombosis (DVT) is a preventable postoperative complication that poses significant risks to patient safety. This evidence-based practice project applies the Iowa Model of Evidence-Based Practice to implement a mandatory DVT prophylaxis training module for newly hired surgical nurses. The training includes interactive instruction on pharmacologic and mechanical prevention methods, such as anticoagulant use, sequential compression devices, and early ambulation. Effectiveness will be evaluated through post-training assessments, observation of nursing practice, and manager feedback. By standardizing DVT prevention education and promoting consistent use of evidence-based interventions, this project seeks to improve nurse competency, reduce postoperative DVT incidence, and enhance …

Preventing Falls On Trauma Units: A Nurse-Led Initiative For New Graduates, Callie Brown, Erin Mytt

Scholars Week

Patient falls are a leading cause of preventable injury in hospital trauma units. This nurse-led initiative introduces a structured educational program based on Dorothea Orem's Self-Care Deficit Theory to strengthen new nurses' skills and act as reinforcement for veteran nurses in fall prevention. The program includes risk assessment, envrionmental safety checks, patient education, nurse education and safe transfer training. Evidence from recent studies supports edcuation based, multidisciplinary interventions as the most effective strategy to reduce hospital falls. Implemented in phases, the intiative requires all new graduate trauma nurses to complete fall prevention training within six months of hire. Expected outcomes …

Psych Assessment In The Er, Bailey J. Thompson, Addie Cowger, Hailie Hollis

Scholars Week

An immense amount of patients who enter the emergency department, whether for a psychiatric illness or not, struggle with mental health challenges. By creating a standardized routine and checklists for the care of high-risk psychiatric patients, the new quality and consistency can enhance patient experiences. This process will start at the triage stage and continue throughout their stay. Presenting the supportive research to the emergency department staff and introducing these changes gradually will help with staff buy-in and become a more sustainable process. Finally, with a structured approach, psychiatric patient outcomes will benefit significantly.

Implementing Diabetes Education And Prevention Protocol, Lilyanna B. Conkle, Alyssa M. Woodall

Scholars Week

This Evidence-Based Practice project proposes the implementation of a diabetes education and prevention protocol in school systems to address the rising prevalence of diabetes among students. The initiative includes mandatory pre-academic year training for school staff to improve recognition and response to diabetes related emergencies. To support school nurses, often the sole healthcare provider on campus; a mobile app will be introduced to alert personnel during emergencies and provide evidence-based intervention steps. This approach aims to enhance student safety, improve health outcomes, and ensure timely, coordinated care.

Implementation Of No Wake Times, Chloe Martin, Drew Mullinax

Scholars Week

Hospitalized patients frequently experience poor sleep quality due to clinical activities that occur during typical sleeping hours such as vital sign checks and medication administration. These nighttime disruptions negatively impact patient recovery times and decrease patient satisfaction. This evidence-based practice evaluated if restructuring nighttime clinical activities would minimize sleep disturbances and improve sleep quality in hospitalized patients. Patient surveys were used to assess the frequency of nighttime awakenings as well as the different sources of these awakenings. Interventions included moving nighttime clinical activities (blood pressure checks and medication administrations) to not be done during the hours of 10pm to 5am …