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Staff Education to Address Medication Noncompliance in Outpatient Behavioral Health Settings
Get PDFThis quality improvement project is a staff education initiative designed to address psychotropic medication noncompliance in an outpatient behavioral health clinic setting. The project arose from the identification of a significant gap in staff knowledge and confidence related to medication adherence strategies. Medication noncompliance in psychiatric care is associated with symptom exacerbation, increased hospitalization, and poorer patient outcomes, making it a critical issue in nursing practice. The practice-focused question guiding the project was: In an outpatient behavioral health clinic setting, does implementing a structured staff education program improve staff knowledge and confidence in addressing medication noncompliance? Analytical strategies included a review and synthesis of research and nonresearch evidence using validated appraisal tools. I collected evidence from 10 scholarly sources. A stakeholder analysis; strengths, weaknesses, opportunities, and threats analysis; and translation planning tool supported the project’s alignment and feasibility. Participants’ pretest scores averaged 48%, while their posttest scores rose to an average of 85.2%, reflecting a normalized learning gain of 77%. Staff reported higher confidence in applying motivational interviewing techniques, culturally responsive care, and adherence support strategies following the education program. Key products included a staff education checklist, instructional materials, and an evaluation plan. The project holds important implications for nursing practice by empowering staff to apply evidence-based strategies in medication adherence counseling. The project supports positive social change by improving mental health outcomes among underserved populations and aligning with culturally tailored content and a patient-centered framework
Implementing Strategies to Reduce Hospital Readmission Reduction Program Readmissions by Improving Discharge Planning in Nonprofit Hospitals
Get PDFNon-profit healthcare administrators in United States hospitals face the challenge of hospital readmissions, especially due to the CMS Hospital Readmission Reduction Program (HRRP), which affects reimbursement. The purpose and review question for this integrative review was to research evidence-based strategies that could be implemented to improve the discharge planning process in non-profit hospitals and reduce readmissions for patients with HRRP diagnoses. A review of literature identified 126 articles for analysis, with 25 studies selected for quality assessment using the Johns Hopkins Nursing Evidence-Based Practice Model and the Research Evidence Appraisal form. The Donabedian framework provided a structured approach for evaluating the effectiveness and efficiency of healthcare delivery services. Five major themes were used to determine the recommendations: assessing patients\u27 living conditions, enhancing discharge education, shared decision-making, fortifying the hospital staff team, and developing a care-continuation plan. Additionally, nine subthemes strengthened the main themes: addressing patient risks for HRRP readmissions, identifying patient support systems and economic needs, strengthening health information, applying teach-back techniques, establishing appropriate goals, encouraging patient and family input, care team collaboration, post-discharge follow-up, and remote medication monitoring. Recommendations for enhancing discharge planning and promoting positive social change include fostering collaboration between physicians and staff, promoting patient and family engagement, forming multidisciplinary teams, and advancing patient education
Accessible Mental Health Chicago
Get PDFGoal Statement: My prevention-focused goal statement for Accessible Mental Health Chicago is to create a program that focuses on providing mental health resources for all in all areas of Chicago. This is by having community based low-cost or no-cost mental health services throughout the city, in the local languages that are of that community.
Significant Findings: While there are some limited resources in the areas with the highest calls for mental health crisis, they are not accessible for most of the city. While there are mental health centers throughout the city there aren’t many low or no cost resources. This means that people are having to wait until they are in crisis to receive the necessary treatment. This also means that barriers such as transportation, finance, and stigma can make it impossible for individuals to maintain mental health even after treatment. While currently only 7 of the 77 communities in Chicago have CARES programs in their access the goal is to with a program like Accessible Mental Health Chicago access can be created for all (Compass, 2025).
Objectives/Strategies/Interventions/Next Steps: The next steps would be to look at the neighborhoods that fall outside of the community range for the current low or no cost centers and focus on expanding by adding to the next larges volume of calls. Once those locations are determined based on public transportation access and necessity, the next step would be to work with local cost based mental health centers as well as school counselors and other community resources to see what the needs of the community are. This would include language needs, cultural needs, and other community-based needs. The third step would be to contact other established resources to work with them on needs-based referrals, for example Community Counseling Centers of Chicago (C4) or Center on Halsted. For these clients who might normally drop out early in treatment due to financial or transportation barriers, they could have some of these barriers removed. The fourth step would be to gain feedback from stakeholders and community about the center’s successes and areas for improvement. The fifth step would be to ensure that the community is aware of the resources available. This would be through media, including social media, as well as within school programs
PROJECT SCOPE AND MARKET SHARE OF SELECTED TELECOMMUNICATION FIRMS IN NIGERIA
Get PDFTo maintain market share, telecommunication operators in Nigeria invest in complex, innovative projects with large budgets and tight timelines. Managing the project scope of these endeavors is a challenge, although crucial to ensuring that viable products are released and guaranteeing market share among these firms. This study examined the project scope and market share of selected telecommunication firms in Nigeria through the quantitative method and survey research. The study employed a validated adapted questionnaire, which used a six-point Likert-type scale and was administered to the study participants to collect primary data. The reliability test of the questionnaire was achieved with Cronbach alpha values and was between 0.734 and 0.756. The population for the study consisted of 94 project team members selected from three telecommunication firms; the sample size was total enumeration. Data analysis and test of hypothesis were conducted with descriptive and inferential statistics. Analysis result revealed that project scope had a statistically positive and significant effect on market share of selected telecommunication firms in Nigeria (β = 0.245, t = 5.779,
A Qualitative Study Exploring the Prenatal Care Experiences of Pregnant and Postpartum Women in Arochukwu, Nigeria
Get PDFThis basic qualitative research study explored the perceptions and lived experiences of pregnant and postpartum women in Arochukwu, Abia State, Nigeria, where access to quality prenatal and maternal healthcare is limited. Nigeria records the highest maternal and infant mortality rates in sub-Saharan Africa, largely due to weak healthcare systems, poverty, and entrenched sociocultural norms. Grounded in the Health Belief Model (HBM) and guided by the lens of social constructivism, the study explored how health beliefs, perceived risks, benefits, barriers, and cues to action shaped women’s healthcare decisions. Using semistructured, open-ended interviews with 13 purposefully selected women, the study captured how age, education, socioeconomic status, gender norms, and religious or traditional beliefs influenced their access to care and decision-making. Thematic analysis revealed five key themes: the centrality of family and male decision-makers, the influence of traditional and religious beliefs, generational disparities, education and class divides, and negative experiences within healthcare settings. Findings also highlighted how intersections of age, gender, social class, and education uniquely impacted women’s health behaviors and outcomes. This study provides important insights into the structural and cultural barriers that impede maternal health and suggests the need for intersectional, community-based, and policy-driven interventions to promote positive maternal health outcomes and reduce mortality rates in Nigeria
Effective Employee Retention Strategies to Maintain Generation Y Employees
Get PDFEmployee retention for Generation Y workers is still an ongoing challenge for human resource managers. To foster a stable and productive workforce, it is crucial for HR managers to understand and apply effective retention strategies. Grounded in Herzberg’s two-factor motivation theory, this qualitative pragmatic inquiry study aims to identify effective employee retention strategies that human resources managers employ to retain their Generation Y employees. The targeted participants consisted of six human resource managers in the United States who had effectively utilized retention strategies to retain their Generation Y employees. Data were collected using semi structured interviews. Using thematic analysis, five themes emerged: (1) work-life balance, (2) employee recognition, (3) Career Advancement and personal growth, (4) competitive compensation, and lastly (5) employee benefits. A key recommendation is for human resources managers to conduct a comprehensive study that tracks Generation Y employees over a 3–to 5-year period to better understand how employee retention factors evolve throughout their career progression. The implication for positive social change includes the potential for HR managers to implement tailored training and career development programs, which mat foster a more dynamic and engaged Generation Y workforce
Strategies to Recruit and Retain Physicians in Rural Hospital Health Systems
Get PDFPhysician shortages in rural areas represent a serious and escalating challenge in the United States, with approximately 20% of the population residing in these regions while only about 9% of physicians practice there. The purpose of this integrative review was to identify key underlying factors contributing to physician shortages in rural hospital health settings and identify potential strategies to recruit and retain physicians. The review question concerned strategies and practices administrators use to attract and retain physicians in underserved rural areas. Herzberg’s two-factor theory serves as the framework and offers a perspective on employee motivation and job satisfaction. A review of empirical and nonempirical literature published from 2019 to 2025 identified 125 articles. After exclusion criteria were applied, 25 articles were identified for in-depth analysis using the Johns Hopkins evidence-based practice model. The articles provided five main themes: improving physician education, strengthening physician autonomy, financial incentives, support for lifestyle/personal preferences, and enhancing understanding of government policies. Fourteen subthemes aligned with the main themes; the most significant were training and education opportunities, personal and professional development, positive work environment, a sense of belonging, and financial support programs. Recommendations included developing targeted recruitment strategies, offering rural-focused medical education, promoting professional collaboration, and encouraging community integration. Implementing these recommendations may enhance access to physicians in rural hospital health systems, thereby strengthening various social determinants of health and contributing to improved health outcomes for residents, ultimately fostering positive social change
Early Childhood Special Education Teachers’ Perspectives of Teaching Social-Emotional Skills During the COVID-19 Pandemic Virtual Learning Period
Get PDFDuring the COVID-19 pandemic, early childhood special education teachers struggled to virtually teach social-emotional skills to their students when schools were closed, and all students were moved from face-to-face to virtual learning. The purpose of this basic qualitative study was to explore early childhood special education teachers’ perspectives on teaching social-emotional skills to their students during the COVID-19 pandemic virtual learning period. Vygotsky’s sociocultural theory was used as the conceptual framework for this study. Data were collected through semistructured interviews with 10 early childhood special education teachers from the United States who had experience with teaching social-emotional skills virtually during the COVID-19 school closure period. Using open coding, the thematic analysis yielded three themes which summarized how teachers; (a) noted specific resources and parental involvement as key to success in virtual learning, (b) noted technology issues, monitoring, and authentic interactions as challenges during virtual learning, and (c) require assistance with parental involvement, data, and specific strategies when teaching social-emotional skills virtually. This study may contribute to positive social change by providing teachers, administrators, and professional development creators with special education teachers’ perspectives on their successes and challenges of teaching virtually so policies and training can be adjusted to improve social-emotional teaching strategies
Adult-Child Caregivers’ Fear and Coping Regarding the Risk of Inheriting Alzheimer’s Disease
Get PDFCaring for elderly parents with Alzheimer’s disease (AD) poses two major challenges for adult-child caregivers: the tasks involved in taking care of ailing parents and also potentially living in fear of developing the same disease. This research examined how caregivers with such fear regard their vulnerability to AD and how they manage the stress that comes with caregiving for someone with a disease they dread developing themselves. This grounded theory study employed the appraisal theory of emotions and the theory of moods as frameworks and aimed to establish awareness regarding coping strategies that adult-child caregivers have about caretaking and their likelihood of developing AD. Semi-structured interviews were conducted via videoconference with 12 caregivers recruited through an AD support group as well as online through social media sites. The data was analyzed for emergent themes using coding derived from comparative methods focused on coping strategies. The findings indicated that caregivers experience significant anxiety about their future health, which they manage through various coping mechanisms such as seeking information, emotional support, lifestyle changes, and mindfulness. Despite these challenges, some caregivers reported positive outcomes, including strengthened family bonds and personal growth. The findings of this study may be used to promote social change by indicating the importance of identifying coping-based interventions that may enable caregivers to manage their fear and enhance quality of life for themselves and their parent with AD. The results may also assist healthcare professionals in the delivery of support services to caregivers of parents with AD
Implementing Clinical Guidelines to Improve the Number of Inpatient Visits at a Mental Health Clinic
Get PDFThis DNP quality improvement project focused on addressing a critical gap in psychiatric care: the high rate of missed inpatient mental health visits. Missed follow-up appointments after hospital discharge are associated with medication nonadherence, relapse, hospital readmissions, psychiatric decompensation, and increased emergency department use. In severe cases, they may increase suicide risk. Contributing factors include patient-level barriers such as cognitive impairment, socioeconomic instability, stigma, low motivation, and transportation difficulties, as well as systemic issues like inadequate discharge planning and lack of standardized follow-up protocols. The evidence-based practice question guiding this project was: Will a clinical practice guideline (CPG) improve number of visits at mental health clinic? This DNP project aimed to develop and implement a nurse-led, evidence-informed CPG to enhance continuity of care. The CPG included interventions such as 24-hour short messages (SMS) and phone reminders, appointment cards distributed at discharge, and verbal reinforcement of the importance of follow-up visits. The CPG was evaluated by four expert reviewers using the AGREE II instrument. Mean scaled domain scores were Scope and Purpose (70.8%), Stakeholder Involvement (75.7%), Rigor of Development (69.3%), Clarity of Presentation (90.3%), Applicability (88.5%), and Editorial Independence (83.3%). Reviewers concluded it was evidence-based, feasible, and appropriate for integration, recommending adoption with minor enhancements such as same-day reminders and structured follow-up. The guideline shows strong potential to improve visit adherence, reduce readmissions, and support equitable, patient-centered psychiatric care