Implementation Of A Provider-Focused Multimodal Educational Initiative To Address Polypharmacy And High-Risk Medication Use In A Home And Community Medicare Advantage Setting, Jennifer Butler-Rickard, Kellie Olsen, Eileen Stuart-Shor, Craig Drew

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Community-dwelling adults are at risk for adverse drug events such as falls, hospitalizations, cognitive decline, drug-to-drug interactions, and mortality related to high-risk medication use and polypharmacy, often defined as concurrent use of five or more different medications. Lack of provider knowledge of polypharmacy and high-risk medication use as well as suboptimal communication with primary care providers can lead to gaps in medication management in this vulnerable population.

LOCAL PROBLEM: Patients seen by the Comprehensive Annual Health Assessment Program advanced practice clinicians (APCs) at the project Medicare Advantage insurer organization often experience polypharmacy. Given the lack of provider knowledge of …

Improving Emergency Preparedness: Disaster Response Gap Executive Summary, Yunuen Pamatz Rangel, Angela Reine Palapos, Edward Vladimir Bondarenko, Sarah Marie Wilson, Semhar Misgina Mehari, Benjamin Lee Lucas

Nursing Leadership in Community Engagement Projects

Improving Emergency Preparedness: Disaster Response Gap Executive Summary

Universities in Washington State have a responsibility to maintain both educational continuity and campus safety, particularly because of the region’s vulnerability to major earthquakes. Although many institutions maintain emergency preparedness plans, the accessibility and strategic placement of emergency resources remain critical concerns. At a private university in Seattle, Washington, the project team identified gaps in earthquake preparedness related to the accessibility, visibility, and availability of emergency supplies.

This project aimed to develop a practical and achievable proposal for university leadership to strengthen disaster preparedness efforts. The project focused on improving access to …

Staff Education To Improve Treatment Adherence Among Young Adults With Mental Health And Substance Use Disorders In An Outpatient Behavioral Health Clinic, Nkechinyere Eririma Nwachukwu

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Fall Prevention Knowledge In A Transitional Care Unit, David M. Ogato

Walden Dissertations and Doctoral Studies

No abstract provided.

Probiotic Intake Related To Hemoglobin A1c Among U.S. Veterans With Type 2 Diabetes Mellitus, Maryann Martin

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Icu Nurses’ Knowledge And Confidence In End-Of-Life Care Through A Structured Education Intervention, Alyssia Lee Wright

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education On Reducing Falls In Psychiatric Inpatient Care Through A Nurse-Led Multifactorial Education And Prevention Program, Marceline Nkwenti

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Reduce The Incidence Of Pressure Injury In Medical-Surgical Inpatients, Francis Omelu

Walden Dissertations and Doctoral Studies

No abstract provided.

Experiences Of First-Generation Immigrant Parents In Caring For Children With Type 1 Diabetes, Nahel Kibreab

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Antihypertensive Medication Adherence Through Patient-Centered Assessment In Rural Primary Care, Tiesha Keoni Mathis

Walden Dissertations and Doctoral Studies

No abstract provided.

An Emotional Intelligence Staff Education Program For Patient-Aligned Care Team (Pact) Members, Linda Rogers

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Nursing Compliance With Pressure Injury Prevention In Postoperative Patients In The Cardiovascular Intensive Care Unit, Chingyi Lam

Doctor of Nursing Practice Final Project Abstract

Pressure injuries acquired in the hospital continue to be a major concern in patient safety among critically ill populations. The purpose of the quality improvement project was to improve nursing compliance with pressure injury prevention strategies among postoperative patients in a cardiovascular intensive care unit (CVICU). Patients who undergo cardiovascular surgery are at a high risk of developing pressure injuries due to immobility, sedation, vasopressors, and prolonged positioning on their backs. The quality improvement project was carried out in a 37-bed CVICU using the Institute for Healthcare Improvement (IHI) Model for Improvement and Plan–Do–Study–Act (PDSA) cycles. Data on nursing repositioning …

Evaluation Of Spontaneous Awakening And Breathing Trials Prior To Mechanical Ventilator Extubation To Enhance Intensive Care Unit Liberation, Shelby Taranto

Doctoral Projects

Spontaneous Awakening and Breathing Trials (SAT/SBT) might be central to early extubation by decreasing total ventilator time and reducing the intensive care unit (ICU) length of stay (LOS). Unfortunately, these trials often have not been conducted consistently in the ICU. The purpose of this research was to evaluate the frequency of SAT/SBT performed prior to mechanical ventilator extubation on total ventilator time in hours and LOS. Quality improvement aims were: (1) to ascertain if an extubation readiness tool could be easily followed and documented, and (2) to evaluate if an extubation readiness tool would add value in clinical practice. A …

Postpartum Depression: A National Crisis Calling For Federal Support, Sarah A. Stallsworth

Doctor of Nursing Practice Final Manuscripts

Postpartum depression (PPD) is the leading cause of maternal mortality in the United States, yet it remains significantly underdiagnosed and undertreated. Despite decades of research illuminating its prevalence and detrimental consequences, federal intervention has been limited.  States retain responsibility to address the issue and possess inconsistent and limited legislation.  The purpose of this paper is to propose adding PPD screening as a National Performance Measure (NPM) within the Title V Maternal and Child (MCH) block grant. MCH is a longstanding and resourceful program that provides states funds to address maternal mental health needs. This proposal suggests leveraging a PPD NPM …

Implementing Cbt-I Coach App Education During Initial Psychiatric Evaluations At The Va Pec: A Provider-Facing Quality Improvement Initiative, Sarah J. Kang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project aims to increase provider implementation of gold standard insomnia treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), by integrating CBT-I Coach app education into initial psychiatric evaluations within a VA psychiatric emergency clinic (PEC).

Background: Insomnia is highly prevalent among veterans and commonly co-occurs with PTSD, depression, and anxiety. National guidelines from the VA, DoD, and American Academy of Sleep Medicine endorse CBT-I as first-line treatment. Despite this, pharmacotherapy is the dominating intervention in psychiatric emergency settings. The CBT-I Coach app offers evidence-based CBT-I as a free, VA-developed digital tool, but it remains underutilized in acute …

Closing The Detection Gap: Early Recognition Of Hospital Onset Sepsis With News2, Anthony Bernardo

Doctor of Nursing Practice Final Manuscripts

Sepsis is the leading cause of in-hospital death and the most expensive inpatient condition in the United States, yet federal quality policy still relies on outdated Systemic Inflammatory Response Syndrome (SIRS) criteria in the Centers for Medicare & Medicaid Services (CMS) Severe Sepsis and Septic Shock Management Bundle (SEP-1), creating fragmented, inequitable recognition of hospital-onset sepsis across U.S. acute-care hospitals. This health policy analysis evaluates the National Early Warning Score 2 (NEWS2) as an evidence-aligned replacement for SIRS-based SEP-1 trigger criteria within a hybrid governmental-organizational policy strategy for adult acute care inpatients. Guided by Kingdon's Multiple Streams Framework and an …

Improving Nurse Competency In Vascular Occlusion Prevention And Management, Arielle Victoria Madayag

Doctor of Nursing Practice Final Manuscripts

Background: Vascular occlusion is a rare, but serious complication of dermal filler injections that can lead to severe adverse outcomes, including tissue necrosis and vision loss. As the demand for minimally invasive cosmetic procedures increases, proper nurse education and preparedness in managing vascular complications remain essential to ensuring patient safety.

Purpose: To evaluate the effectiveness of a structured educational session combined with simulation-based training on nurses’ knowledge, confidence, and clinical competency in recognizing and managing vascular occlusion associated with dermal filler injections.

Methods: A pretest-posttest educational intervention design was used. Four registered nurses (N=4) employed at a medical spa participated …

Enhancing Primary Care Provider’S Knowledge And Use Of Long-Acting And Oral Naltrexone In The Management Of Opioid And Alcohol Use Disorder, Ariana Juarez-Moncada

Doctor of Nursing Practice Final Manuscripts

Abstract

Objective: This evidence-based project aimed to enhance primary care provider knowledge and prescription rates of naltrexone and long-acting injectable (LAI) naltrexone in a community healthcare setting.

Background: Naltrexone and LAI naltrexone pharmacotherapy is shown to reduce use of alcohol and opioids and improve client retention in patients with alcohol use disorder (AUD) and opioid use disorder (OUD) (Bahji et al., 2020; Morley et al., 2024; Murphy et al., 2022).

Methods: A 30-minute in-service was provided to 14 family practice providers at the clinic. The prescription rate of naltrexone and LAI naltrexone was evaluated for the baseline period of February …

Empowering Recovery: Implementing Ace Screenings To Enhance Care For Patients With Substance Use Disorders, Joshua Wolf

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project evaluated the impact of implementing adverse childhood experience (ACE) screenings for patients with substance use disorders (SUDs) in an outpatient community behavioral health clinic.

Background: ACEs are strongly associated with an increased risk of developing SUDs, chronic medical comorbidities, and negative treatment outcomes. Despite consistent evidence supporting the need for identification of ACEs and implementing trauma-informed care, standardized ACE screening is not routinely incorporated into outpatient SUD treatment, potentially limiting the identification of the need for education and referrals.

Methods: The ACE Questionnaire for Adults was implemented during routine psychiatric visits for patients diagnosed with …

Intimate Partner Violence Screening And Awareness Pilot Project, Eleasha P. Partner

Doctor of Nursing Practice (DNP) Projects

Background: In the United States, one in four women experiences intimate partner violence (IPV), highlighting the critical need for improved screening and intervention within the healthcare system. Routine visits in healthcare settings present a significant opportunity for healthcare providers to identify and address IPV.

Local Problem: A primary care family practice clinic in San Leandro, California , currently lacks a standardized evidence-based screening toolkit for IPV.  The absence of such a toolkit creates a gap in practice, leaving patients at risk of undiagnosed IPV and its related consequences.  To address this gap, there is a pressing need for the development …