Digital Commons Network^™

Debriefing Orientation For Novice Simulation Faculty, Cindy M. Carter

Doctor of Nursing Practice Projects

Faculty new to the simulation environment lack the knowledge, skills, and confidence to deliver proper debriefing methods. The Doctor of Nursing Practice (DNP) project’s problem is the need for a standardized, evidence-based debriefing process in the undergraduate RN program at the College of Nursing in Oklahoma. The study aims to follow the International Nursing Association for Clinical Simulation and Learning (INACSL) best practices to implement a debriefing simulation for novice faculty to improve faculty self-efficacy with the debriefing process (Decker et al., 2021). The DNP student evaluated faculty using pre-and post-tests containing questions from the Debriefing Assessment for Simulation in …

Educating Nursing Faculty In Mindfulness Practices To Reduce Students’ Anxiety Pre-Simulation, Virginia Gonzalez

Doctor of Nursing Practice Projects

This DNP project examines how mindfulness training for associate degree nursing faculty can enhance educator self-efficacy in implementing teaching methods that reduce anxiety among nursing students before simulation exercises. The primary issue identified is the lack of faculty training in pre-simulation facilitation practices, which is crucial for ensuring students are adequately prepared. Using a pre-test/post-test design, this initiative evaluated changes in educator mindfulness self-efficacy among 14 faculty members. Results indicated a significant improvement in self-efficacy scores. The pre-test mean score was 3.36, which rose to a post-test mean score of 4.60. These project results demonstrate that mindfulness training effectively enhanced …

Increasing High-Alert Medication Administration Competence In Undergraduate Nursing Students Using An Unfolding Obstetrical Simulation, Jenna A. Warf

Doctor of Nursing Practice Projects

This DNP project aimed to increase medication competence in undergraduate nursing students through an unfolding high-fidelity simulation. Before the implementation of this project, students at the project site had experienced minimal exposure to obstetrical nursing care and medication administration. This quality improvement project occurred at a community college in Texas, with undergraduate nursing students (n=18). The participants completed an Evolve pretest, unfolding high-fidelity simulation, Simulation Effectiveness Tool-Modified (SET-M) survey, and an Evolve posttest. The unfolding simulation consisted of a three-part simulation with a preeclamptic obstetrical patient that started at a physician’s office, progressed to triage, and ended as an inpatient …

Improving Hypertension Management In The Family Care Practice Through The Education Of Clinical Staff On Jnc-8 Guidelines, Shiny Michael

Doctor of Nursing Practice Projects

Hypertension is a major public health challenge, contributing significantly to global morbidity and mortality. Despite the availability of JNC-8 guidelines, adherence in clinical practice is often lacking. This project aimed to improve hypertension management in a primary care setting by educating clinical staff on the JNC-8 guidelines to enhance adherence to evidence-based practices. The primary purpose of this project was to address the lack of knowledge and suboptimal hypertension control through targeted educational interventions for clinical staff. The methodological approach involved a pre- and post-intervention design, with educational sessions conducted for medical assistants. Data on blood pressure control and staff …

Nursing Shortage Crisis: Can Implementing Supplemental Instruction Impact Nursing Students' Success In Nursing Programs?, Lauren Smith

Doctor of Nursing Practice Projects

This quality improvement project (QI) aimed to provide nursing students in the traditional Bachelor of Science in Nursing (BSN) program with different forms of supplemental instruction (SI). The problem identified considered that nursing students' success rates have been dwindling for years, decreasing the number of nurses available. The purpose was to evaluate the effectiveness of SI in promoting student success throughout the semester. SI was first introduced at the University of Missouri-Kansas City in 1973 and is utilized primarily to improve student success in courses that are often considered "high-risk" for failure (Bowman et al., 2021). When SI is appropriately …

Quality Improvement Project: Evaluating The Impact Of An Intrapreneurial Skill Enhancement Program On Enhancing Innovation Perspectives And Overcoming Obstacles Among Nurse Practitioners At A Midwestern Academic Medical Center, Michael Thorn

Doctor of Nursing Practice Projects

Nurse practitioners (NPs) face barriers to being innovative in healthcare because of a need for more resources, education, and cultural inclusion compared to physicians and researchers (Joseph et al., 2019). NPs are often disregarded from involvement in the innovation ecosystem and seen as solely end-users of new products and services (Davis & Glasgow, 2020). This Doctor of Nursing Practice project aimed to assess the impact of a 5-week innovation and intrapreneurship course on NPs' perceptions of their ability to innovate at a Midwest academic hospital. The aim was to address the known innovation education gap that NPs rarely receive. Using …

Quality Improvement Project Integrating Telemedicine To Reduce Patient No-Shows, Ferdinand Akoko

Doctor of Nursing Practice Projects

No-show among psychiatric outpatient clinic patients is a major problem due to disrupted clinical flow, reduced productivity, and financial losses. This quality improvement project implemented telehealth services to decrease the no-show rates in an outpatient psychiatric clinic in Texas. This project employed quantitative methods to compare the no-show rates pre- and post-intervention for 90 days. The quantitative data were analyzed by paired t-tests. A total of 1,790 appointments were sampled during the implementation period. The obtained results are statistically significant in decreasing the rates of no-shows for all adult appointments from 18% to 13% (p ≈ 0.0067). New appointment no-shows …

Quality Improvement Project: Incivility In Nursing Education: Utilizing An Educational Module And Professionalism Guide To Address Incivility In A Nursing Students, Jennifer Schadler

Doctor of Nursing Practice Projects

Incivility is a well-documented issue in the nursing profession that begins in nursing education and follows graduates into nursing practice. Nursing academia has a responsibility to address incivility to prevent inappropriate behaviors from becoming embedded into the culture. The problem addressed in this quality improvement project is incivility among nursing students at a private college. The purpose of this project was to apply evidence-based incivility interventions to address uncivil behaviors of nursing students. The hypothesis was that the implementation of a civility mentor module and professionalism guide would impact perceived incivility among nursing students. The project was conducted using the …

Health Policy: Food Allergy Restaurant Education Law, Joanna Ko

Doctor of Nursing Practice Projects

Food allergies are a rising public health concern with no indication of deceleration. The purpose of this Doctor of Nursing Practice (DNP) project is to enact an Arkansas state law to protect the food allergy community in dining out at restaurants to increase quality of life and decrease adverse allergic reactions. The current Arkansas state legislation for restaurant food allergy employee training is absent and action needs to be taken to safeguard the food allergy community from life-threatening reactions. The methodology involved contacting the six states that have previously implemented similar food allergy legislation. It encompassed performing a thorough search …

Determining The Impact Of A Diabetes Logbook In Improving Self-Care Among African Americans With Type 2 Diabetes, Winifred Moore

Doctor of Nursing Practice Projects

Type 2 diabetes is a prevalent chronic disorder that is associated with defects in the metabolism of glucose. The management of type 2 diabetes depends on patients’ adherence to self-care activities. However, patients at the project site reported poor glycemic control, which increased their risk of diabetes complications. The purpose of this quality improvement project was to educate nursing staff on the use of diabetes logbooks to improve self-care among African Americans with type 2 diabetes and thereafter have the nursing staff educate diabetic patients. A quasi-experimental pre-post-intervention design involving 30 African American adults (mean age 43.70 years) with uncontrolled …

Enhancing Student Simulation Debriefing Using Video Recording, Lisa Hall

Doctor of Nursing Practice Projects

This quality improvement project aimed to show how video recording can increase vivid feedback by expanding the students' memory by reviewing the recording to recall and reflect on their roles during the simulations. This project sought to help the learner understand how well the simulation ran and what was done to improve its performance. The interventions involved video recording each simulation scenario. The recording was used during the debriefing session to help the students recall and reflect on their actions during the scenario. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data was collected using …

Impact Of Gamification In An Online Rn To Bsn Program, Deosha Anderson

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance student engagement in an online RN to BSN program by incorporating gamification strategies into the curriculum. Traditional teaching methods often fail to maintain student interest, leading to low engagement and reduced program completion rates. This project sought to determine the impact of gamification on student engagement compared to no gamification. The intervention involved integrating gamified elements into the online RN to BSN program to create a more interactive learning environment. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data on student engagement metrics, including login frequency, time spent …

From Knowledge Gap To Empowerment: Patient-Operated Insulin Pump Management For Bedside Nurses, Bernadette J. Amao

Doctor of Nursing Practice Projects

Acute care nurses often struggle with the complexities of managing patient-operated insulin pumps (PIPs) due to limitations in training. With the rising prevalence of insulin pumps, equipping nurses with the necessary skills to navigate these devices effectively is essential. This quality improvement project addressed this critical gap by enhancing bedside nurses' self-efficacy in PIP management. Drawing upon Bandura's self-efficacy theory, this project hypothesized that targeted educational interventions could significantly improve nurses' confidence in managing PIPs. A four-week educational program was implemented to cover basic knowledge, troubleshooting, and patient interaction aspects of insulin pump management. The intervention tool was designed to …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

Optimizing Digital Proficiency To Improve Perceived Self-Efficacy In Telehealth Nurses, Serena Young

Doctor of Nursing Practice Projects

The use of telehealth to provide care management services has increased as healthcare continues to evolve. Seven million Americans were predicted to use telehealth in 2020, which increased to over 35 million through the pandemic. These services have been shown to decrease healthcare disparities and promote positive health outcomes. Education and training for nurses providing telehealth services have not kept up with the increased demand. Nurses providing care management telehealth services in a large tertiary health system have low perceived self-efficacy for technology. Leaders in the organization believe this is causing a lack of digital proficiency in their workforce. This …

A Wellness Initiative: Mindfulness Training For Unlicensed Assistive Personnel To Promote Self-Care And Enhanced Well-Being, Julia Aurora Clarke Msn, Rn, Cns

Doctor of Nursing Practice Projects

Background: Burnout leads to decreased staff engagement, productivity, and high attrition rates. The nursing staff most impacted are Unlicensed Assistive Personnel (UAP); therefore, to combat burnout, resilience is to be cultivated. Resilience begins with self-care, which is nurturing the self: mind, body, and soul to safeguard well-being.

Objectives: This project provided mindfulness training as a wellness initiative to promote self-care skills and enhance well-being among the UAP within a healthcare facility.

Methods: This project followed an evidenced-based quality improvement practice framework ( Mindful Self-Care Scale-Brief and IHI- Well-Being Assessment Survey) and used a pre-post-test design to compare …

Improving Empathy With Simulation: A Quality Improvement Project, Jami Layne

Doctor of Nursing Practice Projects

This study examines the effectiveness of simulation-based training in enhancing empathy levels among undergraduate nursing students. A lack of empathy can negatively impact the healthcare outcomes of patients (Levett-Jones et al., 2019). Improving the empathy levels of nursing students can improve patient outcomes and impact student learning outcomes such as the student’s ability to think critically and improve communication and social skills (Chua et al., 2021; Ferri et al., 2017; Hakansson Eklund et al., 2019; Koukourikos et al., 2021). The purpose of the quality improvement project was to improve empathy levels in undergraduate associate degree nursing students and increase the …

Lncreasing Clinical Judgment And Critical Thinking Skills Using The Ncsbn Clinical Judgment Measurement Model In Licensed Nursing, Kathryn Roberts

Doctor of Nursing Practice Projects

Licensed nurses are having problems with critical thinking and using clinical judgment when caring for patients (Rogers & Franklin, 2023). There has been increased emphasis on critical thinking and clinical judgment in nursing school curriculum but not in hospital/orientation curriculum (Dickison et al., 2019). This quality improvement project aims to address the gaps in critical thinking and clinical judgment skills among licensed nurses by focusing on integrating the NCSBN-CJM, and cues into the prebriefing of the Respiratory Distress/Oversedation Scenario within the project hospital orientation program. The project utilized a quasi-experimental study design to investigate the cause-and-effect relationship by integrating the …

Medication For Opioid Use Disorder In A Community Mental Health Clinic, Hannah Magness

Doctor of Nursing Practice Projects

Background: Over 100,000 people died from opioid-related overdoses in the United States in 2023. People experiencing homelessness (PEH) are at especially high risk of co-occurring mental illness and substance use disorder, and face added barriers to accessing medical and psychiatric care. Buprenorphine is a life-saving medication used to treat opioid use disorder (OUD).

Objective: This project assessed the feasibility of altering prescribing practices at a community mental health clinic in King County, Washington to incorporate medication for opioid use disorder (MOUD) into standard clinic procedures.

Methods: This project was a mixed-methods, formative evaluation that assessed the need for and barriers …

Evaluating The Effectiveness Of A Vaginal Breech Birth Training Program, Kathleen Lynch, Rachel Mackriell

Doctor of Nursing Practice Projects

Introduction: Most providers do not have the skills, knowledge, or confidence to safely support vaginal breech birth (VBB) despite 3-5% of all pregnancies being breech at term. The presence of a provider skilled in VBB reduces risk in VBB, however VBB skills are not a standard part of birth provider training. Identifying an effective instruction method can make VBB training more accessible.

Methods: We conducted a secondary data analysis of 3940 surveys submitted by self-selected participants in an international hybrid VBB training program from May 2021 to February 2024. Pre- to post-training analysis using non-paired t-test and chi-squared comparison was …

Implementation Of Non-Pharmacological Sleep Checklist In Adult Intensive Care Unit (Icu) To Decrease Delirium, Recine Anne Alinea, Nancy Lamptey

Doctor of Nursing Practice Projects

Background: Delirium is a prevalent problem in Intensive Care Unit (ICU) patients, affecting up to 80% and resulting in poor outcomes such as increased length of stay in the hospital, prolonged hospitalization, cognitive impairment, and sometimes death. Nonpharmacological therapies, particularly those that promote sleep, have been found to prevent delirium.

Objective/Aim: To determine the efficacy of a nonpharmacological sleep checklist intervention in lowering the incidence of delirium in ICU patients and increasing nurses' knowledge and confidence in the implementation of the sleep bundle/checklist.

Method: A quality improvement project with a pre-post mixed methods design was carried out in a 28-bed …

Improving Access To Early Interventions For Prediabetic Patients, Kimberleigh M. Telling

Doctor of Nursing Practice Projects

Approximately 88 million Americans, or nearly one-third of the population, have prediabetes. This condition has a high rate of progression to type 2 diabetes, reaching 70%. However, early identification, diagnosis, and participation in lifestyle interventions can effectively reduce the risk and promote euglycemia. Regrettably, 85% of those with prediabetes are unaware. The goal of this quantitative quality improvement project was to enhance the use of the prediabetes diagnosis code by primary care providers, who play a crucial role in preventing type 2 diabetes. The purpose was to improve access to early intervention for individuals with prediabetes, following the guidelines of …

Implementing A Foot Screening Project For Diabetic Patients In An Assisted Living Facility, Beatrice L. Bailey

Doctor of Nursing Practice Projects

Diabetes impacts around 422 million individuals globally, resulting in 1.5 million reported annual deaths. Type 2 diabetes affects approximately 35.4% of the population in the United States, with 1.4 million new cases identified each year. When not managed properly, diabetes can spiral into a long list of complications. Among the various challenges in diabetes management, foot complications stand out as significant and often avoidable. Without proper attention, these complications can lead to severe health issues. To address this concern, this project focuses on resolving standard foot inspection practices within an assisted living facility in central Mississippi. The goal is to …

Conflict Resolution In Healthcare: The Vital Role Of Developing Conflict Management Skills Among Nurse Leaders, Kris Maddalena

Doctor of Nursing Practice Projects

Nurse leaders at the unit level play a vital and indispensable role in acute care settings. Their influence extends beyond administrative tasks, as they significantly impact crucial factors such as nurse retention rates, patient outcomes, and the overall work environment of the unit-level teams. Effective unit-level leadership has been consistently associated with improved outcomes, increased job satisfaction, and decreased turnover among nurses (Aiken et al., 2011). This DNP project is focused on enhancing conflict management skills among unit-level nurse leaders in an acute care setting. The project followed a quality improvement sequence, which included obtaining a needs assessment for unit-level …

Improving Outcomes For Women Following Gynecological Surgery Through Implementation Of Multimodal Analgesia As Part Of An Enhanced Recovery After Surgery (Eras) Protocol, Shannan M. Case

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has been a continuous public health crisis, as opioid-associated overdose has become one of the leading causes of death. The risk of opioid misuse increases following exposure to opioids perioperatively. As a result, anesthesia providers are facing a significant shift in practice to decrease opioid administration while adequately managing perioperative pain. While opioids have historically been the mainstream for perioperative pain management, multimodal analgesic (MMA) regimens as part of Enhanced Recovery After Surgery (ERAS) programs are being utilized as alternative methods. With these programs, opioids are reduced by administering non-opioids with neuraxial and …

The Implementation Of A Diabetic Foot Screening Tool Into A Primary Care Practice, Joanna P. Barnett

Doctor of Nursing Practice Projects

Inconsistent guidelines and nonadherence to diabetic foot screening recommendations are ongoing problems. This project aimed to promote the prevention of diabetic foot complications by detecting complications early and determining who is at high risk. An educational intervention provided for clinicians addressing the importance of foot assessments and the use of a diabetic foot screening tool was provided. After the education was provided, a pre-and post-test comparison was assessed for increased knowledge. Due to a small sample size and the need to assess results quickly, the plan-do-study-act method guided the project. Post-intervention, the goal was to have four providers increase the …

Implementation Of The Adult Adhd Self-Report Scale In A Mental Health Clinic, Anne Hocking

Doctor of Nursing Practice Projects

Less than 20% of adults with attention deficit hyperactivity disorder (ADHD) are adequately treated due to overlapping symptomology of comorbid psychiatric conditions. Anxiety and depression are the most common comorbid psychiatric conditions in adults with ADHD. Diagnosis, treatment, and outcomes of adults with ADHD are impacted due to inadequate screening. The setting for this project occurred in a Veteran Affairs mental health outpatient clinic in central Illinois. The process was implemented by screening adults diagnosed with depression or anxiety using the adult ADHD self-report scale (ASRS). Of the 150 participants, 90 scored higher than 17 on the self-report scale, indicating …

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …

Improving Nursing Communication By Implementing Communication Tools In A Bsn Undergraduate Program To Improve Patient Outcomes In Practice, Christopher Jackson

Doctor of Nursing Practice Projects

Communication deficiencies were identified among baccalaureate nursing students at South College in Nashville, TN, necessitating changes needing to be made in the nursing curricula. To address the flaws, the quality improvement project proposed implementing changes in clinical assignments during clinical rotations in medical-surgical nursing courses. The project manager discussed the purpose and usage of the SBAR tool, and the students then demonstrated the use of the tool. The clinical faculty rated the students using an eight-question Likert survey to assess the students’ confidence and competency three times; the first assessment at the end of the shift without guidance from their …

Utilizing A Multidisciplinary Team Approach To Opioid Stewardship At An Interventional Pain Clinic, Georgemarie Garber

Doctor of Nursing Practice Projects

Background: The opioid epidemic is a preventable health threat that is a recognized national problem by the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS). The evidence-based Opioid Stewardship (OS) toolkit is essential in the opioid epidemic because it supports identifying patients at risk for opioid aberrancy. However, at the Interventional Pain Management Clinic (IPMC), a chart review on the completion rates of the OS toolkit components for new patients admitted in June 2022 revealed that providers were not consistently completing components of the OS toolkit such as Opioid Risk Tool (ORT), the Morphine …