Nursing Commons^™

Ageism From The Perspectives Of Diploma Program Nursing Students After An Aging Simulation: A Phenomenological Reflection, Melissa Suzanne Jones

Doctoral Dissertations and Projects

Ageism in the healthcare system creates a challenge for nurses and their patients. Knowledge is needed regarding sensory changes that occur with normal aging. This knowledge gap leads to stereotyping and missed opportunities for age-appropriate care. Nurses must recognize that hearing loss and naturally occurring vision changes can lead to poor outcomes and social isolation in older adults. In addition, caring for older adults becomes less desirable to nurses entering practice because of negative perceptions about older adults. However, nursing programs can address ageism by augmenting the curriculum with a geriatric sensitivity simulation. Through a series of exercises that simulate …

Implementation Of Social Support Assessment In Patients Aged 65 And Older With Type 2 Diabetes Mellitus To Improve Treatment Adherence In A Primary Care Setting, Angela Allen-Blaine

Doctoral Dissertations and Projects

Background: There is a growing number of adults aged 65 years and older living with type 2 diabetes. Research shows this population is at a higher risk of losing independence due to diabetic complications. Social support is a key component to help assist patients with taking medications properly, preparing diabetic meals and monitoring blood glucose. Adequate social support may improve the quality of health and well-being in older adults. Social support is not routinely assessed in primary care, but it is routinely treated. This evidence-based practice project aimed to educate clinicians about social support assessment and facilitate implementation of a …

A Qualitative Study Of Registered Nurses’ Perceptions Of The Impact Communication Modalities Have On Patient Care Outcomes In Primary Care, Eleanor M. Chapital

Doctoral Dissertations and Projects

Communication plays a vital role in the provision of patient care and directly impacts patient care outcomes across the care continuum. The purpose of this qualitative study was to explore and determine registered nurses’ perceptions of the communication modalities that facilitate optimum patient care outcomes in the primary care setting. Registered nurses play a critical role in the provision and coordination of patient care. Therefore, it is imperative to study their experiences and perceptions to facilitate communication within primary care teams. The central research question for this study was the following: How do registered nurses describe their use of communication …

Evidence Based Orientation And Mentorship: A Solution To Decreased Job Satisfaction And Performance Amongst Healthcare Techs In The Emergency Department, Paige E. Fleming

Doctoral Dissertations and Projects

Healthcare technician support in high-volume emergency departments (EDs) is often inadequate, leading to challenges in job satisfaction, confidence, and competence. This project implemented an evidence-based orientation and mentorship program to enhance these factors among healthcare techs. Using a nonrandomized before-after design, participants underwent structured mentorship and orientation, with outcomes measured through pre- and post-intervention surveys, competency assessments, and feedback forms. Data analysis employed descriptive and inferential statistics to evaluate changes in job satisfaction, confidence, and competence. Results demonstrated measurable improvements in all three areas, supporting the effectiveness of structured mentorship in professional development and retention.

Enhancing Access To Medication-Assisted Treatment (Mat) For Minority Inmates In The San Diego Prison System: A Quality Improvement Through Culturally Competent Approach, Douglas Seangmany

Doctor of Nursing Practice (DNP) Projects

Abstract

Background The opioid crisis disproportionately affects racial and ethnic minority groups, particularly in correctional settings. In San Diego’s prison system, only 20% of incarcerated individuals with Opioid Use Disorder (OUD) receive Medication-Assisted Treatment (MAT), highlighting significant care disparities.

Local Problem Limited access to MAT among minority inmates contributes to poorer health outcomes, higher overdose rates, and increased healthcare costs. Addressing these disparities is crucial for improving health equity within the prison system.

Methods A review of 10 studies emphasized the importance of culturally competent care in improving treatment engagement and outcomes among minority populations. To address disparities, the intervention …

Clinical Practice Patient Education Guideline For Patients With Substance Use Disorders, Josephine Nandzo

Walden Dissertations and Doctoral Studies

The Veteran’s hospital for which this DNP clinical practice patient education guideline (CPPEG) was developed has made strides in addressing the needs of patients with substance use disorders (SUDs). However, the problem identified for this project was the need for veterans with SUDs to obtain information about resources available in the hospital, community, or state to manage their recovery. The project question was as follows: Will a CPPEG on resources for patients with SUDs meet the optimal threshold of 7 on the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument? The purpose was to plan, implement, and evaluate …

Influence Of Nurse’S Knowledge And Attitudes On Caring Behaviors For People With Opioid Use Disorder, Inyene E. Essien-Aleksi, Don Roosan, Tracie Mcpadden, Leslie Rideout, Michael Martin, Paula-Jo Beniers, Amy Lund, Danielle Leone-Sheehan, Alysse Wurcel

Health Sciences Faculty Publications

Background: Opioid use disorder (OUD) remains the leading cause of preventable substance use-related deaths in the U.S. Each year, more than 1 million Americans seek hospital care for OUD-related issues. However, they often receive inadequate treatment and face barriers such as limited overdose prevention education, delays in medication initiation, and insufficient post-discharge follow-up. Nurses are well-positioned to improve inpatient OUD treatment, yet qualitative research suggests they often have limited knowledge and negative attitudes toward OUD, which can decrease the level of compassion and empathy nurses have toward people with OUD. Validated instruments, such as the Care Behavior Index (CBI-6) and …

Staff Education On Physical Activity As A Therapeutic Option For Anxiety And Depression, Suja Paul

Walden Dissertations and Doctoral Studies

This project’s aim was to educate staff on physical activity (PA) as a therapeutic option for anxiety and depression to relieve psychotic symptoms, enhancing patients’ quality of life. PA enhances cognitive functioning, reduces anxiety and depression, and decreases the risk of cardiovascular conditions and early death. Patients with severe mental illnesses face barriers to PA and exercise, so providers and policymakers must create an environment that encourages participation. A knowledge gap for staff exists in promoting PA in mental health patients. Healthcare professionals should recommend the right amount of PA for each patient. This initiative aims to increase staff confidence …

Pain Management Educational Module For Nursing Staff, Kathyrina Lucy Pham

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in pain management among nursing staff in the rehabilitation unit. Frequent pain-related patient calls contributed to inconsistent clinical practices. This project aimed to evaluate whether a brief, evidence-based educational intervention could enhance nurses’ knowledge of pain management. 47 registered nurses participated in an educational module delivered during both day and night shifts. Pre- and post-test scores were collected and analyzed to assess knowledge acquisition. T-test results indicated a statistically significant improvement in nurses’ pain management knowledge. The findings support the effectiveness of brief, targeted education in promoting clinical outcomes …

Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda

Walden Dissertations and Doctoral Studies

Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

From Awareness To Action: Enhancing Medication Safety Culture To Improve Outcomes, Joseph A. Mensah

Doctoral Dissertations and Projects

The purpose of this project was to evaluate how a culture of medication safety can improve healthcare outcomes. Medication errors persist and remain the leading cause of preventable injury, highlighting the necessity to enhance the culture of medication safety in healthcare. The population for this project included clinical staff within a military healthcare setting. A quantitative survey assessed perceptions of medication safety, confidence levels, and obstacles to error reporting within the organization. The survey results revealed that 28% of clinical staff had not received medication safety training in the past year, 55% were not confident in medication administration, and 25% …

Undergraduate Nursing Students' Perceptions Of Faculty Mentorship For Student Success In Persevering Toward Program Completion: A Qualitative Study, Shirley C. Callihan

Doctoral Dissertations and Projects

The purpose of this qualitative exploratory single case study is to explore the undergraduate nursing students' perceptions of faculty mentorship for student success in persevering toward program completion. The theory guiding this study is the Roy Adaptation Model (RAM) by Callista Roy, as it relates to nursing students' adaptation to the challenges in their environment through faculty mentorship. The central question is: What are undergraduate nursing students' perceptions concerning faculty mentorship for student academic success in persevering toward program completion? Convenience sampling was used to recruit ten participants who were undergraduate nursing students from a Registered Nursing program in the …

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

Doctoral Dissertations and Projects

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

Remind: Raising Awareness Of Nurse Burnout Using An Educational Intervention, Emily Louise Missimer

Doctoral Dissertations and Projects

Burnout is an international occupational phenomenon that can negatively impact one’s physical, emotional, and psychological well-being. Although burnout affects all occupations, professionals working in the healthcare field are known to be at high risk for occupational burnout secondary to factors such as high-stress environments, critically ill patients, increased patient care requirements, frequent exposure to mortality, and shiftwork with long hours, among other factors. Of the subgroup of healthcare providers, it is also widely known that nurses who have a high exposure to death, such as hospice nurses, are at an even higher risk for occupational burnout. At a hospice care …

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

Doctor of Nursing Practice Final Manuscripts

Abstract

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

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

Doctor of Nursing Practice Final Manuscripts

Abstract

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

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

Doctor of Nursing Practice Final Manuscripts

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

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

Doctor of Nursing Practice Final Manuscripts

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

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

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

Walden Dissertations and Doctoral Studies

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

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

Doctor of Nursing Practice Final Manuscripts

Abstract

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

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

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

Walden Dissertations and Doctoral Studies

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

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

School of Public Health Faculty Publications

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Journal of Interprofessional Practice and Collaboration

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

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

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