Nursing Commons^™

Implementation Of An Evidence-Based, Standardized Hypertension Follow-Up Protocol To Improve Quality And Outcomes Among African American Females In A Primary Care Setting, Fausat Oluremi Ojo

Walden Dissertations and Doctoral Studies

Hypertension is a major modifiable risk factor for cardiovascular disease, stroke, kidney disease, and premature mortality. African American women experience a disproportionate burden of hypertension and hypertension-related complications, making timely follow-up and treatment intensification essential quality and equity priorities. This evidence-based practice project implemented a standardized hypertension follow-up protocol in a primary care setting to improve blood pressure (BP) control and follow-up reliability among African American females ages 18 to 65 with a hypertension diagnosis. The project population included 67 patients, numbered 1 to 67. Baseline BP report data showed that 47 patients had BP less than 140/90 mm Hg, …

Staff Education Project To Increase Nursing Staff Knowledge Of Falls Prevention In Long-Term Care Facility, Oludele Olagoke

Walden Dissertations and Doctoral Studies

Falls among residents in long-term care facilities are a concern for families and facility management. Falls inflict pain, discomfort, and head trauma, causing fractures. In nursing practice, falls are nursing-sensitive indicators that reflect the quality of nursing care and patient safety. There is a need to bridge the gap and increase staff knowledge on how to prevent falls in the facility. The Doctor of Nursing Practice (DNP) project focused on increased nursing staff knowledge through an evidence-based education program and the implementation of an evidence-based practice education program. The DNP project practice question was about nursing staff in long-term care …

Organization Change Process Evaluation Improving Phq-9 Completion Following Positive Phq-2 Screenings In An Outpatient Behavioral Health Setting, Diana Pieterson

Walden Dissertations and Doctoral Studies

Depression is a leading cause of disability worldwide and is associated with significant impairment, delayed treatment, and increased suicide risk when not appropriately identified and managed. In an outpatient behavioral health setting, review of de-identified electronic health record (EHR) data identified inconsistent completion of the Patient Health Questionnaire-9 (PHQ-9) following positive Patient Health Questionnaire-2 (PHQ-2) screenings, resulting in incomplete depression assessment and missed opportunities for timely intervention. This Doctor of Nursing Practice (DNP) project evaluated whether implementation of a standardized PHQ-2 to PHQ-9 workflow improved PHQ-9 completion rates among adult outpatients with positive PHQ-2 screenings. The organization change process included …

Staff Education On Psychoeducation Delivery To Enhance Medication-Adherence Education For Adults With Bipolar Disorder In An Outpatient Psychiatric Mental Health Facility, Bibiana Chinwe Ndula

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed inconsistent delivery of evidence-based medication-adherence psychoeducation for adults with bipolar disorder (BD) in an outpatient psychiatric mental health facility. The project question was whether an 8-week structured module, in relation to existing staff education practices, would increase staff knowledge and confidence. The intervention was guided by the Johns Hopkins evidence-based practice (JHEBP) model and comprised a PowerPoint presentation, a facilitator guide, a handout, a checklist, a toolkit, and anonymous pre- and post-training assessments. Eight out of ten invited staff completed the project. The mean knowledge rose from 6.1 to 8.9 …

Staff Education To Standardize Chronic Pain Patient Education In Primary Care, Jessica Okpara

Walden Dissertations and Doctoral Studies

Inconsistent delivery and documentation of chronic pain patient education may contribute to variations in patient knowledge, treatment expectations, and engagement in self-management. This Doctor of Nursing Practice staff education and quality improvement project was designed to standardize chronic pain patient education in a primary care setting. The practice-focused question examined whether implementing standardized chronic pain education, compared with non-standardized education, would improve patient knowledge and use of self-management strategies over 10 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model, the project included development of evidence-based education materials, staff preparation, workflow integration, and a standardized documentation process. Clinic staff identified …

Reducing Medication Administration Errors Through Implementation Of An Electronic Medication Administration Safety Dashboard, Myrlande Daguindeau

Walden Dissertations and Doctoral Studies

The DNP project was a quality improvement (QI) initiative designed to reduce medication administration errors by integrating an electronic medication administration safety dashboard (BCMA) at Sheppard Pratt Hospital in Elkridge, Maryland. The purpose of the project was to evaluate the effectiveness of a medication safety dashboard in providing automated clinical alerts to improve real-time monitoring and support safer medication administration practices. The project was informed by the prevalence of medication administration errors in the psychiatric unit attributed to factors such as frequent adjustments of medication and interruptions during the medication administration process. Data were collected from the hospital’s records and …

Improving Glycemic Control And Self-Care Among Adult Patients With Type 2 Diabetes Mellitus At A Community Health Center, Lydia Asabea Lartey

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a significant practice concern in community health settings, where adults often encounter barriers to effective self-management, including low health literacy, socioeconomic challenges, and limited access to Diabetes Self-Management Education and Support (DSMES). At the project site, inconsistent staff preparation, high patient volume, and limited standardized teaching resources contributed to gaps between evidence-based standards and routine diabetes education. To address these gaps, the project implemented a standardized, culturally responsive diabetes-education workflow to strengthen care quality, patient safety, and responsible resource use. The practice question guiding the project was: How does implementing a standardized, culturally responsive …

Staff Education To Improve Knowledge And Confidence In A1c Screening For Adults With Serious Mental Illness, Veronica Akweley Odoi

Walden Dissertations and Doctoral Studies

This project was conducted to observe the effects of staff education on staff knowledge and confidence regarding metabolic risk and hemoglobin A1c (A1C) monitoring for adults with serious mental illness in a crisis response unit. The lack of a streamlined system in metabolic testing in recent times has led to nuances in metabolic testing for patients with serious mental illness. The practice-focused question asked whether evidence-based staff education on A1C monitoring, and provider roles would improve staff knowledge and confidence. The purpose of the education is to strengthen knowledge of metabolic risk, A1C screening expectations, role clarity, workflow, and staff …

Reducing Nurse Burnout, Oluwarotimi Tunde Aborisade

Walden Dissertations and Doctoral Studies

Nurse burnout is a severe job-related condition that significantly impacts nurses' well-being. Nurse burnout is a growing concern amid the increased demand for healthcare professionals. Research has been conducted to explore nurse burnout and how it affects the quality and safety of patients. Different research has also been conducted to review different interventions to address nurse burnout, including individual and organizational interventions. Some interventions include self-care, mindfulness and meditation, coping and resilience, as well as lifestyle adjustments. Some organizational interventions include workload management, psychological safety, and job redesign. This study was conducted to evaluate the effectiveness of individual interventions to …

Staff Education To Providers Prescribing Glp-1 Medications For The Treatment Of Obesity, Madeleine Williams

Walden Dissertations and Doctoral Studies

The utilization of glucagon-like peptide 1 (GLP-1) medications has skyrocketed over the past 5–8 years, with an average weight loss of 15–21% of initial weight. Unfortunately, not all providers offer evidence-based patient education when starting a GLP-1 medication for the treatment of obesity. A practice gap I have identified is the lack of consistent evidence-based education providers utilize when prescribing GLP-1 for obesity treatment in the primary care setting. The project site was a hospital-based primary care clinic located in a suburban community in Washington. This staff education aimed to evaluate whether a standardized, evidence-based educational tool on GLP-1 medications …

Implementation Of A Nightshift Sleep Promotion Bundle To Support Delirium Prevention In A Neurosurgical Intensive Care Unit, Pamella Simpson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project aimed to identify the need for a consistent sleep-promotion protocol in an adult neurosurgical intensive care unit (NSICU). Disrupted sleep is a frequent problem for patients who are seriously ill and can lead to delirium, longer hospital stays, higher health care expenses, diminished cognitive function, and death. While there was evidence supporting nonpharmacological sleep-promotion and delirium-risk-reduction interventions, they were not consistently implemented at the project site, creating a gap between evidence and clinical practice. The purpose of this project was to implement and evaluate an evidence-based night-shift sleep-promotion bundle. The practice-focused …

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …

Improving Identification And Initial Management Of Perimenopause In Primary Care, Yewande Banire

Walden Dissertations and Doctoral Studies

Perimenopause is a common but frequently underrecognized stage of reproductive aging that can significantly affect women's physical, psychological, cognitive, and sexual well-being. In primary care, inconsistent provider education and the absence of standardized screening and assessment processes often contribute to delayed recognition and fragmented management. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based clinical practice guideline to improve the identification and initial management of perimenopause in a primary care setting. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved synthesizing and critically appraising the literature to develop …

Educating Psychiatric Mental Health Nurse Practitioners On Long-Acting Injectable Antipsychotic Medication Management, Omonzua Mabel Eromosele

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project addressed the underutilization of long-acting injectable (LAI) antipsychotic medications in an outpatient mental health center. Although LAI antipsychotics improve medication adherence, reduce relapse, and decrease psychiatric hospitalization, provider knowledge deficits and inconsistent prescribing practices lead to their underuse. The practice-focused question was: Among psychiatric-mental health nurse practitioners (PMHNPs) in an outpatient mental health center, what is the impact of an educational program on the application of LAI antipsychotic medication management on the improvement of staff knowledge? The purpose of this project was to implement and evaluate evidence-based educational intervention to improve …

10-Bed Medical-Surgical Telemetry Unit Expansion To Address Inadequate Inpatient Capacity, Sumitpal Kaur

Walden Dissertations and Doctoral Studies

Inadequate medical-surgical telemetry capacity contributes to emergency department (ED) boarding, patient transfers, decreased patient satisfaction, and operational inefficiencies. This systems-level organizational leadership project evaluated a proposed 10-bed medical-surgical telemetry unit expansion at a medical center in Northern California. The project addressed the question of how a 10-bed expansion would affect ED boarding, patient crossovers to a nearby medical center, patient satisfaction, and financial performance. Trend analysis of occupancy, ED boarding, and crossover data, regional benchmarking, and financial modeling using net present value (NPV) and internal rate of return (IRR) were used to evaluate the proposed expansion. The organization currently operates …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Sustaining Clabsi Prevention Through Central Line Bundle Compliance: A Focus On Iv Tubing Labeling, Visual Cues And Peer Support, See Elizabeth Vang

Master's Projects and Capstones

Abstract  

Problem: Inconsistent IV tubing labeling compliance on a telemetry unit was identified as a gap in central line maintenance practices that could affect adherence to the CLABSI prevention bundle.

Intervention: A quality improvement project reinforced existing IV tubing labeling practices through a visual job aid, staff education, and peer verification during Nursing Knowledge Exchange (NKE) bedside handoff.

Outcome Measure: The primary outcome measure was IV tubing labeling compliance, with a goal of increasing compliance from 86.5% to at least 95% on 24 bed Telemetry unit.

Results: The project did not achieve the desired improvement in compliance. Multiple concurrent quality …

Enhancing Cultural Competency Through Training In A Primary Care Clinic, Rogelio Perez Iii

Doctor of Nursing Practice Projects

Cultural competence remains essential in primary care settings serving diverse populations, yet staff at a small Southern Texas primary care clinic reported no previous formal cultural competency training in workplace orientation or school. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a brief, evidence-based cultural competency intervention improved clinician cultural competency scores. Madeleine Leininger’s Culture Care Theory provided the theoretical framework, Lewin’s Change Theory guided the change process, and the Plan-Do-Study-Act cycle directed implementation and evaluation. The problem addressed was the lack of structured training to support culturally responsive communication, patient trust, and …

Impacting Competency In C-Ssrs Suicide Risk Screening On An Inpatient Psychiatric Unit, Fidelis Sangye

Doctor of Nursing Practice Projects

Suicide remains a leading public health concern, and inconsistent application of the Columbia-Suicide Severity Rating Scale (C-SSRS) may contribute to variability in suicide risk assessment and delayed intervention within inpatient psychiatric settings. The purpose of this quality improvement (QI) project was to evaluate the effectiveness of a standardized C-SSRS-guided educational intervention on staff competency in suicide risk screening. Guided by Lewin’s Change Theory and implemented using the Plan-Do-Study-Act (PDSA) framework, this quantitative pretest-posttest QI project was conducted on an adult inpatient psychiatric unit. The intervention consisted of a 25-minute instructor-led PowerPoint presentation on standardized C-SSRS administration and evidence-based suicide risk …